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July 16, 1910

A CASE OF RETROGRADE PUBERTY, IMPOTENCE AND DIABETES INSIPIDUS, RELIEVED BY SUPRARENAL CORTEX

JAMA. 1910;55(3):215. doi:10.1001/jama.1910.04330030037012

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Abstract

History.—  In 1897, H., aged 27, married, developed (1) polyuria without sugar, 120 to 150 ounces daily; (2) retrograde puberty; i. e., atrophy of testes, disappearance of beard, pubic and axillary hair, the scalp hair remaining luxuriant. The condition, called diabetes insipidus by the physicians consulted, had existed for twelve years, when, in 1909, the patient was referred to me.

Diagnosis.—  The polyuria and retrograde puberty suggested an excess of pituitary secretion. As an x-ray picture of the pituitary region by Dr. Reichmann revealed nothing abnormal, the pituitary excess was assumed to be not absolute, but relative, possibly from deficient secretion by the adrenal cortex.

Treatment.—  After thyroid substance, and later adrenalin (which is derived from the adrenal medulla only), had proved futile, he was given daily four grains of suprarenal substance, containing cortex as well as medulla.

Result.—  Improvement was prompt and distinct; after four months of this medication

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