Endocrinology of anorexia nervosa.

THE physicians who earliest described anorexia nervosa considered it it to be of psychologic origin. Morton in 1689 (1), Naudeau in 1789 (2), Gull in 1874 (3), and Laseque in 1873 (4) attributed the cachexia to emotional disturbances and this conclusion has been reaffirmed by the great majority of subsequent investigators. However, the existence of an endocrinologic deficiency in these patients has been periodically suggested. This has been prompted by the presence of amenorrhea and a low basal metabolic rate. Simmonds' description of panhypopituitarism contributed to this opinion, since it inadvertently fostered the misconception that cachexia is a cardinal feature of hypophyseal failure and led to confusion of this disease with anorexia nervosa. Furthermore, some authors have been averse to a psychologic explanation of such a profound physiologic catastrophe. More recently certain metabolic and histologic abnormalities have been described which have been interpreted as further evidence of endocrinologic...