328 ALLAN WINTER ROWE 



record 30, 40, or even 50 per cent below that of the first test. The correlated 

 physical measurements of pulse, blood pressure, and the like are helpful 

 in reaching an estimate of the authority of any given reading. With the 

 nervously unstable — a class in which the ovarian patient certainly falls — 

 the best that one can hope for from even repeated tests is frequently no 

 more than to establish the existing trend. 



The sugar tolerance is studied with galactose, a carbohydrate peculiarly 

 adapted to this form of investigation (2). While failure of the posterior 

 lobe determines a massive increase in the power of the organism to utilize 

 the sugar, ovarian failure depresses the tolerance in some cases to a level 

 but one-half of that of the normal adult. Thyroid failure shows the same 

 directional influence as the pituitary but in very modest degree, fully two- 

 thirds showing normal levels and the remainder increases of a very moderate 

 degree. 



Time is lacking to consider the differential features of a number of other 

 special tests which form part of the routine of study and which possess 

 tangible diagnostic value. To illustrate, the eye examination in the pitui- 

 tary group will frequently demonstrate yellowish discs, enlarged blind 

 spots and some contraction of the form and color fields. 



For the same cause, discussion must be reserved on those non-endocrine 

 conditions which simulate endocrinopathies, such as hepatic dysfunction 

 and syphilis, the pituitary, or primary anaemia and leukaemia, the thyroid. 



Enough has been said, it is hoped, to indicate that in the study of the 

 factors causative to human infertility the evaluation of the endocrine status 

 is of prime importance. And that further, if the function levels of the 

 individual members of the endocrine concert are to be evaluated with some 

 degree of precision, careful laboratory and clinical studies must complement 

 and supplement each other. A judicious diagnosis is the synthesis of all 

 of the material deriving from these several sources. 



REFERENCES 



(1) Reynolds, Edward, and Macomber, Donald: Fertility and Sterility in Human 



Marriages, Philadelphia, W. B. Saunders Company, 1924. 



(2) Rowe, A. W.: "Sugar Tolerance as an Aid to Diagnosis," J. A. M. A., 89: 1403 



(1927). 



