INFANTILISM 863 



at least not reduced in size, and the proportions of the skeleton are wholly 

 different from those in children. The complexion of the face in the 

 young eunuchoid is delicate and pale, but soon turns sallow, wrinkled 

 and senile (Geroderma genito-dystrophico). 



However, Peritz, in a recent publication on this subject, again insists 

 with emphasis upon the numerous features that dysgenitalism has in 

 common with the immature state of childhood, justifying its place among 

 the forms of universal infantilism. Such features are deficiency of the 

 genitals, absence of the secondary sexual characters, persistence of the 

 epiphysial junctures, infantile pelvis, infantile cartilaginous larynx with a 

 high-pitched voice, abnormal development of the fat tissue, not unlike the 

 adiposity of children during their stage of "fullness"; progressive growth 

 of all parts of the body, persistence of the thymus and psychic infantilism. 



The abnormal growth is not due so much to hyperfunction of the 

 growth-stimulating organs as to lack of the antagonistic hormons that 

 exercise a restrictive influence on growth, 'the products of normally func- 

 tionating gonads at puberty. 



Not infrequently at the time of rapid growth during puberty a tem- 

 porary lagging behind of the gonads in their development and function 

 leads to a transitory though perhaps well marked syndrome of eunuchoid 

 adiposity that later disappears with the rallying of the endocrin secretion 

 (Prepubertial eunuchoidism). Such a forme fruste is exemplified by 

 Falta's observation (No. 48, page 398), concerning a 13-year-old boy. 



Nanosomia of Hypophysial Origin 



Hypophysial Infantilism. Due to the paramount position the hypoph- 

 ysis holds in the chain of the hormonopoietic system as one of the con- 

 trolling factors of growth and due to its relation to other endocrin glands, 

 especially the genitals, marked developmental anomalies will result from 

 its derangement, whether the latter are caused by a primary disturbance 

 of that organ, such as hypoplasia, tumor or sclerosis, or by other endo- 

 cranial conditions in the vinicity or more remote, that directly or indirectly 

 interfere with its function, such as tumors or hydrocephalus. 



From clinical observation and experimental pathology we know that 

 hypophysial dystrophy, which begins in the young, is followed in most 

 cases by a retardation or cessation of the growth of the skeleton and ossi- 

 fication. The size of the body remains below the average and is occasion- 

 ally decreased to the diminutive measures of veritable dwarfism with a 

 length of only from 56 to 54 inches or less. The external sexual organs 

 remain in an immature state, though occasionally penis and testicles may 

 be normal and functionate well. The perigenital hairs are usually absent 

 or scanty, and in the male have boundaries of the feminine type; the 



