PRECOCIOUS PUBERTY 153 



DERANGEMENTS IN THE FUNCTIONAL DEVELOPMENT OF 

 THE GENITAL ORGANS 



The term ' functional development ' of the genital Derange- 

 organs and secondary female characteristics refers to function de- 

 the changes which normally occur at puberty. The^^ tof 

 advent of functional activity in the genital organs and 

 of the associated secondary sex -characteristics, which 

 become evident at this time, change the girl into a 

 woman. Since the appearance of puberty is dependent 

 on the general metabolism, which is influenced by the 

 internal secretions, we can easily understand how 

 disorders of the hormonopoietic system may affect the 

 phenomena associated with this period of life. 



Precocious Puberty. — The usual age of puberty in Appearance 

 this country is about the end of the fourteenth year, but puberty. 

 the appearance of it between the tenth and sixteenth 

 years cannot strictly be considered abnormal. Heredity, 

 health, feeding and environment all play an important 

 part in the result. When, however, a child under nine 

 years of age shows definite signs of puberty — such as 

 hair on the pubes, development of the breasts, and 

 menstruation — we may look upon the condition as 

 abnormal. 



Now, a close investigation of the recorded cases Etiology of 

 has shown 1 that the production of precocious puberty pu berty. 

 in girls is not due to all those causes which may produce 

 precocity in boys. This is a point of some importance, 

 but future observations possibly may modify the follow- 

 ing statements which are based upon our present 

 somewhat limited knowledge of the subject. 



On the one hand, there is no doubt that in boys Sexual 

 sexual precocity may be produced by neoplasms and i n boys. 

 hyperplasia in the suprarenal cortex, in the testes and 



1 Bell, W. Blair, Proc. Roy. Soc. Med, (Obstet. and Gynaecol. Sect.), 

 1913, vol. vii, p. 47. 



