Abstract

Segregation of the various etiologic factors in hypogonadism as outlined in the previous paper (1) delineates a rational therapeutic approach and permits a definition of the prognosis. Pertinent information elicited from the history often establishes the existence of testicular failure; e.g., surgical extirpation of both testicles, failure induced by roentgen-ray or radium, persistent notvdevelopment or retarded maturation of the sexual system in patients of post-adolescent or adult years and instances, wherein the presumptive diagnosis of testicular failure is ascribable to the metabolic alterations of senescence. The noivexistence of gonadal failure is apparent in instances of proven fertility. The ability to fertilize is the most reliable objective evidence of ample testicular function.

In the first paper of this series (1) it was emphasized that two grades of hypogonadism may exist, depending upon the time of onset of testicular failure, a), initial preadolescent or adolescent testicular failure, and b), adult or intercurrent testicular failure.

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