Treatment of Post-traumatic Simmonds' Disease with Methyl Testosterone Linguets

Abstract

IN 1942 Escamilla and Lisser (3) published a clinical study of Simmonds's disease including a statistical analysis of 595 cases, 101 of which were proved pathologically. A multiplicity of synonyms has been employed in reporting cases, especially the term “hypophyseal cachexia;” more recently, and now more frequently used, is the term “panhypopituitarism,” introduced by Fuller Albright. I t is reminiscent of the term, “hypopituitarismus totalis,” used by Berblinger in 1934. This severe endocrinopathy results from a more or less complete destruction of the pituitary gland, especially of the anterior lobe. This may be caused by a tumor, infarction with necrosis, infection, or it may be consequent to a traumatic injury. The cardinal features of this malady are: (a) a marked loss of weight, often progressing to cachectic emaciation; (b) loss of sexual function—amenorrhea in the female, loss of libido and potentia in the male—and usually sterility in both sexes; (c) a low basal metabolic rate; (d) low excretion levels of follicle-stimulating hormone (6); (e) extremely low or absent excretion of urinary 17-ketosteroids (5).