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May 18, 1940


JAMA. 1940;114(20):1973-1983. doi:10.1001/jama.1940.02810200001001

In the nebulous zone where endocrinology shades into psychiatry as at the climacteric, the puerperium and adolescence, no more elusive figure is to be encountered than the syndrome variously called anorexia nervosa, hypopituitarism or incipient Simmonds' disease.

The following example attempts to portray the experience of the clinician faced with this syndrome, one which is evidently appearing with greater frequency:

The patient is an adolescent girl whose mother states that the girl has been quite well until three months before, when she suddenly, for no apparent cause, completely lost her appetite. Since then the hitherto joyous child has become difficult, shy, restless, even sleepless. Coincident with this change in her personality there has been a progressive loss of weight until she now looks "like a skeleton draped in skin" and her chubby girlish features have changed into an awkward ugliness. Her menstrual periods have ceased, her soft, childlike skin has