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By treating with thyroid extracts a child that has remained backward in his mental development we can make a curious observation. The child who had previously been a cretinous idiot will not only improve bodily but also mentally, and he will be transformed into an intelligent being with normal mental faculties. The logical deduction is that the thyroid must influence powerfully the condition of our nervous system and mentality. Indeed, the physiological activity of the nervous system and mentality depends entirely on the co-operation of the ductless glands with internal secretion. In fact, we do not think we are going too far in saying that the condition of the nervous system and mentality is mainly governed by these glands. The truth of this assertion is shown by the fact that any alteration of these glands, especially the thyroid and sexual glands, and pituitary body, is always followed by alterations of the nervous system. This is strikingly sustained by the elaborate researches of Sajous who found that the reactions of fluids circulating in all nervous elements corresponded with those of internal secretions and particularly that of the adrenals.

Removal of the thyroid also produces far-reaching anatomical changes in the central part of the nervous system which, as we have mentioned, has been described by Albertoni, Tizzoni^[87] Blum,^[88] Walter Edmund,^[89] and others. These consisted of the destruction of nervous cells and nervous processes, chromatolysis, and also the augmentation of the neuroglia, which increases in the same way as the connective tissue in all other organs and tissues.

These changes have been found by Whitwell^[90] also in myxœdematous persons. In accordance with these anatomo-pathological changes we must also expect clinical symptoms, and we shall thus find in persons with degenerated thyroids an idiotic condition termed cretinism, while in persons suffering from myxœdema mentality is considerably altered. Thus Pilcz^[91] notes as typical symptoms of myxœdema: slowness of thought, apathy, defective memory, and somnolence. In fact, after removal of the thyroid gland or after its degeneration by disease, we observe changes in all those functions which, according to our present knowledge of physiology, are situated in the cortex cerebri, such as intelligence, power of imagination, will power, memory, sleep, etc. The thyroid must govern these functions, as they are seriously damaged after the degeneration of this gland. Thus, myxœdematous people think and speak very slowly, have a weakened intelligence, are completely apathetic, and have no will-power, and the memory is either gone or is defective. In the same way, as in old age, myxœdematous people can remember events which have happened a long time ago, but cannot do so as regards recent events—all facts we explain by assuming they are able to remember what has happened at the time prior to the degeneration of the thyroid; but after such a condition they are not able to mirror recent events in the greater brain. The wonderful effect of the thyroid on intelligence can be observed, as above mentioned, in backward or cretinous children who, by means of the thyroid extract, become intelligent children gifted with a better memory. We, ourselves, through personal observation and experiments, observed the fact that thyroid tablets improve the memory (see also Chapter LIII), and it is interesting to mention here the case of a very stout patient who, after the first day of thyroid treatment, felt in such a condition of mental activity that he sat down, in the middle of the night, at his writing table to compose a scientific article instead of going to sleep. We did not mention to this gentleman—a lawyer—anything about the effects that the thyroid might have. Dr. Hertoghe, the well-known authority on the thyroid gland, told us that he sometimes takes before strenuous mental work, such as the delivery of a lecture, three or four thyroid tablets at a single dose. We must not, however, allow ourselves to be seduced to thyroid medication by the action of thyroid on mentality, unless the condition of our gland demands it, for the administration of such extracts in large doses and without special diet and precautions may produce disagreeable symptoms, a description of which we will give in a special chapter on the treatment of old age by means of extracts from the organs of animals.

We have also frequently seen a marked improvement in the mental faculties of adults through thyroid treatment. Thus last winter, during a stay in Nice, we were consulted by an American lady of 69 years who was suffering from arteriosclerosis and dizziness. Through thyroid treatment the intelligence of this lady improved so much that it became very noticeable to her English trained nurse, who told us that whereas before she could do anything with this mentally torpid woman without comment, now she first demanded to know the reason for everything before she complied with the dietary and hygienic measures the nurse wanted her to follow.

That the thyroid gland affects the intellect is also proved by the very important fact that the serum of animals whose thyroid has been extirpated, and which is thus antagonistic to the thyroid gland, is able to impair the intellect. Dürig^[92] noticed this after using large doses of such serum in a woman with Graves’s disease, thereby causing an appearance of great stupidity, loss of memory, and incapability of thinking, so that he had to suspend the treatment. These symptoms continued for fourteen days after the treatment had been discontinued.

Sleep is also one of the functions controlled by the thyroid, and as its changes are able to promote senility, we believe it will be well to discuss this more fully in a special chapter (XLIII).

We cannot recall any alteration of the thyroid gland that is not accompanied by nervous symptoms. In Graves’s disease (exaggerated activity of the thyroid) we observe a condition of great nervousness, so much so that, according to some authorities, Graves’s disease may be termed a neurasthenia with tachycardia. There are many women treated for simple hysteria who are, in fact, suffering from a partial form of Graves’s disease with its cardinal symptom: tachycardia. In cases of Graves’s disease we often find conditions of exaltation, even manias, and very frequently, at the very least, great irritability. On the other hand, in myxœdema there is, usually, a condition of melancholia, and it is interesting in this connection, that in a number of cases of melancholia we have found a swelling of the thyroid with a cessation of the menstrual flow; such cases improved after thyroid treatment, particularly when conjoined with treatment by ovarian extracts. In the lunatic asylum of Pontiac, Michigan, some 100 cases of swelling of the thyroid have been traced out of 600 insane inmates, as we heard on the occasion of our visit to our friend, Dr. Edwin S. Sherril, of Detroit, four years ago.

As we have seen already, the thyroid stands in very close relation to the ovaries, and, as we have often stated, the alteration of the ovaries is very apt to produce a swelling of the thyroid, as witnessed during menstruation, puberty, pregnancy, the puerperium, lactation, and the climacteric. Not only may the thyroid swell in many of these conditions, but the mental system is also changed during each of these processes. Sometimes it may be simple irritability, but at times the changes of the mind may develop into lunacy. Thus, in young girls, we occasionally see in the years of puberty mental changes, such as a tendency to wandering away from home, and even cases of lunacy, the so-called psychoses of puberty. Similar cases of insanity are equally frequent in pregnancy, and during the climacterium or after the experimental climacterium—castration. Again, insanity is not unfrequent in cases of degenerative disease of the ovaries; to such an extent, indeed, that sometimes a gynæcologist can treat a case of insanity in women better than a specialist in psychiatry. Not only in women, but in men changes in the sexual organ always produce far-reaching changes in the mind. Chronic gonorrhœa is the more to be feared on account of its invariably involving the prostate, the inflammation of which, in the same way as that of the testicles, is usually followed by symptoms of neurasthenia. If we now note this and remember that, according to Baldwin, in most cases of hysteria we may find at the autopsy alterations in the ovaries, we shall understand that the author of this book did not go too far when he stated, in a communication to the Belgian Congress of Neurologists, in Brussels, in 1906, that all cases of neurasthenia and hysteria are based upon pathological anatomical alterations, and that it is not true that, in contra-distinction to all other diseases, these should be the only ones without any pathological anatomical foundations. In fact, in nearly all cases of neurasthenia or hysteria we shall find changes in some of the ductless glands, particularly the thyroid, sexual, or pituitary body, if we only take the trouble to search for them. The degenerative alterations of the pituitary body are, as a rule, followed by the symptoms of the disease called acromegaly, and this also presents all the symptoms of a neurasthenic or hysteric condition.

From the foregoing we shall understand why so many people, whether male or female—possibly the latter in greater number—who live in total sexual abstinence, present symptoms of neurasthenia or hysteria; for it has been shown by Rigaud and also by Mingazzini, that animals, living in total sexual abstinence, present alterations in the epithelia of the sexual glands (see Chapter XLVII).

It would be simply hypocrisy and unworthy of a scientific work which should always aspire to reveal the truth, were we to deny the fact that many old bachelors and spinsters present a series of nervous symptoms, especially dyspepsia and hyperchlorhydria and pains in the stomach, far more than other persons, which we must explain by the action of impulses coming from the sexual organs to the sympathetic and pneumogastric, the principal nerves of the stomach and intestines, and thus producing a hyperæsthesia of the nerves of the stomach. In such persons some kinds of food, well digested by a normal stomach, will act as an injurious foreign body, and be felt as such by the over-sensitive stomach nerves, and the gastric glands will respond with a large flow of secretion and much acid upon agencies that produce no such stimulation in a normal stomach.

That the sexual glands also influence the intellect is best proved by the observation that in cases of testicular or ovarian insufficiency intelligence is often diminished. Thus we were consulted by the parents of a young man of eighteen years who was mentally backward; he could not remember anything; his arms and legs were abnormally long, but his body short, thus resembling a eunuch’s—and indeed I found his testicles were not yet descended. His voice was that of a child, and he also exhibited the other symptoms of testicular insufficiency described in the second chapter of this book.

On the other hand we may see a precocious highly developed intellect in children with a premature sexual development. We know of a boy of six years who tried to have sexual intercourse with a little girl of the same age, and who at the age of four and one-half years knew all the capitals of the world by heart. Hence the education of precociously bright children should be especially guarded, for they can become great men but also not rarely, if neglected, great criminals.

As, however, in these days of scepticism we do not believe in anything until demonstrated by experiments (often forgetting the fact that what does for dogs or rabbits does not always do for man) which should only assist our judgment, but not exclusively govern it, we shall have to prove the correctness of our clinical observations on the influence of the sexual glands—i.e., on the nervous system and mentality—by experiment, and we believe we have sufficient facts at hand to do so.

About a hundred years ago it was shown by Gall—who was attacked by several authors, among them Rieger, as innovations always are, but who was also successfully defended by the celebrated German nerve specialist and philosopher, Moebius^[93]—that castrated animals or persons have an alteration in the back part of the skull indicating an impoverishment of the cerebellum. And, indeed, he produces his own evidence and that of several other authorities, Darnecy, Rousseau, etc., which gives the history of several autopsies on castrated persons, all of whom showed an atrophy of this structure. In cases where only one of the testicles was destroyed, this atrophy was always present in the hemisphere of the small brain on the opposite side.

It has been found by numerous authorities that the skull and brain of castrated animals and persons is smaller than the normal. Gall^[94] noted this fact, and after him Vimont,^[95] from experiments on animals; and, according to the latter observer castration of both sides produces a considerable diminution of the cerebellum. Leuret and Hoffmann^[96] found a diminution of the head in horses, sheep, and pigs after such an operation, and that the other parts of the skeleton are always altered is a fact recorded by a large number of authorities as stated already.

As we have pointed out above, any alteration of the testicles or ovaries is followed by nervous disturbances, and, consequently, the total removal of these glands produces far more deleterious effects, and these will vary according to whether such persons have been castrated at an early age or later. In these latter cases nervous disorders will be more acutely felt, and as the celebrated French authority, Dupuytren, states, melancholia is a common phenomenon in castrated men. According to more recent observations in cases of enlargement of the prostate that have been treated by castration, the patients exhibit melancholia. We may here remark that the testicles and the prostate are in close relation, the latter always becoming atrophied after castration. There is experimental evidence to show that a too large amount of testicular or ovarian secretion may produce toxic effects. Thus, Loisel, by injecting testicular or ovarian extracts into animals, could produce toxic symptoms in every instance. This may account for the fact mentioned previously that persons living for a long time in complete sexual abstinence, occasionally exhibit symptoms of disorder of the nervous system.

The marvelous influence of the sexual glands on the mind and character is at once apparent if we consider the aberration from the normal of the castrated person. The authorities who have studied the eunuchs in Egypt and the Skopze in Russia (a religious sect who adopt castration as a tenet), found typical characteristics in these people that distinguished them from the normal.

Thus, as a rule (and as stated by Moebius), the biography of remarkable eunuchs of the old and middle ages shows that they are entirely deficient in courage, which seems to be dependent entirely on the possession of testicles, and the same fact may be noted also in the case of the lower animals. Thus, an ox is a coward compared to a bull, and an ordinary horseman prefers to ride a mare rather than a stallion. The best means of taming certain animals is by depriving them of their testicles at an early age. Intelligence also is much influenced, not only by the thyroid, as already shown, but by the testicles. Thus persons of literary or other fame, such as artists and the like, have become impaired in their capacity after castration: Abelard, for example.

Moebius, in the history of the world, could find no castrates of great intelligence. Knowledge gained by diligent labor is not referred to here. We merely wish to express our conviction that great ideas, such as are found in men of genius, are impossible in men devoid of their testicles; and it appears out of the question to imagine such men as Napoleon, Goethe, or others, as castrates. On the contrary, we are inclined to believe that such great men had a private life that would have rendered them unfit for the position of superintendent of an American Sunday School.

Courage is a specific feature that can only be found in a man who is still in possession of healthy sexual glands; it is entirely wanting in eunuchs. Cowardice, superstition, laziness, avarice, vanity, cruelty, and other bad qualities are typical features in eunuchs. Our friend Sir Hugh Adcock, formerly physician to the late Shah of Persia, told us that his own experience with hundreds of eunuchs showed him that they all had these bad qualities. Capacity for hard work, generosity, kind-heartedness, and religion may be found in persons who are in the possession of healthy, vigorous, sexual glands; but by exhaustion, after sexual excesses, a condition may be created analogous to myxœdema after previous Graves’s disease. This exhaustion of the sexual glands may create a condition in which some of the features of the castrated may appear. This is noticeable in the character of many of the dignitaries of oriental countries who possess large harems, and also in occidental countries in many men who lead a life of debauchery. The influence of the pituitary is shown by changes that invariably occur in the nervous system and mind after any alteration in it. Thus, in two millionaires suffering from acromegaly we have observed great stinginess. We do not intimate that this is a characteristic of millionaires, but these gentlemen were quite the reverse before becoming afflicted with their disease. In one case of acromegaly, for the knowledge of which we are indebted to Dr. Dercum of Philadelphia, there was a great distrust of anything new, even the most useful of innovations. This caused great discontent among the gentleman’s business partners, although he himself showed this disposition only after the symptoms of his disease were apparent. In acromegaly there exists a hyperactivity of the pituitary; Renon was able to produce the disease by giving large doses of pituitary extracts, and Hochenegg obtained good results in his treatment of it by extirpating the pituitary body.

Extirpation of the adrenals is also followed by important alterations in the nervous system, as was noted by Jersoni and others. Also, in Addison’s disease, which is accompanied by a degeneration of these glands, we notice a diminution of the intellect together with a general mental depression.

The influence of the ductless glands on character, and the change in the same after alterations in those glands, may easily lead to crime, as the two principal barriers against crime are will-power, by which we control our passions; and sound judgment, by which we distinguish right from wrong. It is evident that a cretinous or myxœdematous person will have no great will-power, for this, as already shown, is dependent on the thyroid secretion; nor do they possess intelligent sound judgment enough to realize what is right; and, as the possible consequences of their defective action, castrated persons, as above shown, are more attracted to crimes due to avarice or cruelty. Those who are interested in this question may read our lecture delivered before the Medical Jurisprudence Society in Philadelphia,^[97] in which we endeavored to prove in detail our assertions that the origin of crime is due to nervous changes succeeding alterations of the ductless glands. As persons of advanced age often have a complete atrophy of the sexual glands, changes in their character may be explained on these grounds.