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In a recent communication toThe Journalwe1demonstrated that the anterior pituitary-like principle from the urine of pregnant women may produce such marked stimulation of genital growth in young boys that a syndrome resembling premature puberty results. The present paper is concerned with the influence of this material on undescended testes. Since Schapiro's2report eight years ago, the anterior pituitary-like principle has been used extensively in the treatment of this condition. In spite of numerous observations in other clinics showing a high incidence of successful results, we have consistently been unable to produce descent in most instances of true cryptorchidism.3In order to explain this discrepancy a critical survey of the problem is desirable. An analysis of the results of other observers4is given in table 1. It may be seen that there were 860 undescended testes in 579 patients. The condition was bilateral in

Rapidly accumulating evidence clearly shows that the anterior pituitary-like principle from the urine of pregnant women exerts a profound influence on the growth, and function of the male genitalia. It may produce an increase in the size of the penis, scrotum and prostate in both man1and animals2before the age of puberty. The consensus is that in the testis it influences primarily the interstitial cells,3although there is some evidence that the seminiferous tubules may also be affected.4Some increase in the size of the testes has been produced in rats5and monkeys.6In the course of treating patients for undescended testes we have been struck more by its influence on the growth of the genitalia than by its influence on the descent of the testis.7It will be shown that this stimulation of genital growth may be so marked that changes simulating premature puberty are produced.

In April 1937 Albright and his co-workers in Boston reported 5 cases in which were presented the bizarre concurrent features of osteitis fibrosa cystica, areas of pigmentation of the skin and endocrine dysfunction, with premature puberty in the female patients. Although 12 similar cases had previously been reported in the literature under a variety of titles, beginning with Weil's report in 1922, the paper of Albright and his associates was the first to establish this peculiar syndrome as a clinical entity distinctly separate from, rather than an aberrant type of, one of the other known diseases affecting bone. For this reason and because there is no simple term to encompass all the prerequisite elements, in the "Standard Classified Nomenclature of Disease" the term "Osteitis Fibrosa Cystica (Albright)" has been adopted to identify this particular disease picture. CHARACTER OF THE SYNDROME The osseous disorder in this group of cases is one

The effect of supernormal size and strength on the age at which the onset of walking occurs has often been discussed, but no factual evidence relative to the question has ever been adduced. In that connection, the cases of most extreme development are probably the most important, since the greater in excess of normal is the bodily development of the child the greater might be expected to be its effect on the age at which walking begins. The instances of most advanced physical growth in the first and second years of life are undoubtedly those rare cases in which puberty is attained during this period. It has been known since the time of Geoffroy-Saint-Hilaire that premature puberty is preceded and accompanied by an acceleration of skeletal development and of ossification. This is amply shown by the literature on precocious maturity. Smith, in 1822, reported the case of a boy who