938 CHARLES E. DE M. SAJOUS 



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islands of Langerhans, as a cause of diabetes mellitus has come into view. 

 The pancreas is, accordingly, now regarded not only as the producer of 

 an external secretion into the digestive tube but also as a manufacturer of 

 an internal secretion that is poured into the blood to' make the utilization 

 of sugar possible by the tissue cells. If the pancreas be removed experi- 

 mentally in animals, glycosuria follows; but if pancreatic tissue be suc- 

 cessfully grafted even in some remote situation in such animals, the 

 glycosuria will cease. Just how the internal secretion of the pancreas 

 exerts its influence on carbohydrate metabolism has been much discussed 

 and a great deal of experimental work is being done in the hope of set- 

 tling the question. That many factors, other than the internal secretion 

 of the pancreas, should be considered in connection with diabetes mellitus 

 seems certain. I have myself drawn attention to the possible significance 

 of adrenal factors on the one hand and of proteolytic ferments within 

 the leucocytes and other tissue cells on the other hand. It is to be hoped 

 that in the near future the various factors concerned in mobilization and 

 utilization of glucose in the body will be more clearly established than 

 they are now. 



Hypogenitalism (Eunuchism; Eunuchoidism ; Menopause). The 

 world has, from time immemorial, had opportunity to watch the results 

 upon the body and upon the mental state of removal of the testicles in 

 males. Since the introduction of Battey's operation of ovariotomy, we 

 have had manifold opportunity for observing, also, the effects of spaying 

 in women, and particularly of studying the artificial menopause thus pro- 

 duced. 



The effects of castration in man, especially if the operation be done 

 in childhood, are very characteristic. The studies of the sect known 

 as the Skopzi are now familiar to all. An excellent account of these 

 eunuchs is given in the monograph by Tandler and Gross. 



The internal secretion of the gonads, functioning normally, seems 

 to determine: (1) the time of closure of the epiphyseal lines in the long 

 bones, and (2) the development of the secondary sex characters, both 

 physical and mental. 



Males castrated in childhood often grow to be very tall persons and to 

 have long legs and arms on account of the failure of the epiphyseal lines 

 in the long bones of the extremities to close at the usual time. The f acies 

 of eunuchs is characteristic. There is a sleepy look to the eyelids. The 

 distribution of the hairs on the body is abnormal. Thus, the supercilia 

 tend to be scanty especially lateralward; the hairs in the axillae the 

 so-called hirsi are scanty, as are those on the mons Veneris ; and the 

 distribution of the hairs in the latter position is prone to assume the char- 

 acter of that of the opposite sex. The mental state of the eunuch (timid- 

 ity, lack of initiative and of aggressiveness) is well known. Even the 

 breasts may approach the feminine type (gynecomastia). 



