Adolescence, the coming of menstruation, the first blooming of youth is delayed in the subthyroid.  The secondary sex traits as they develop tend to be incomplete and to mimic those of the opposite sex.  Yet in adolescence too there may be a sudden change and reversal of the whole process, a jump from the subthyroid to the hyperthyroid state.  So a girl who has been dull and lackadaisical, with no complexion and every prospect of evolution into a wall flower, may be transformed into a bright-eyed woman, generally nervous and restless, high colored, and possessed of a craving for continual activity and excitement.  Skin, hair and teeth become of the thyroid dominant type.  The heart palpitates under the slightest stimulus, she perspires almost annoyingly, heat and emotion are prostrating.  If such a transfiguration does not occur, the effect of the reconstructions of puberty is to create a person with about the following characteristics.

1.  Height below the average 2.  Tendency to obesity (toward middle age) 3.  Complexion sallow 4.  Hair dry—­hair line high 5.  Eyebrows scanty, either as a whole or in outer half 6.  Eyeballs deep-set, lack lustre, in narrowed slits 7.  Teeth irregular, become carious early 8.  Extremities cold and bluish 9.  Circulation poor.  Subject to chilblains

Intellectually, these people vary enormously, depending upon which of the other glands will enlarge to compensate for the deficiency of the thyroid.  If the growth of the skull has left a roomy sella turcica for the pituitary to grow in, the intellect may be normal or even superior, though energy is below par.  If this is not possible and the adrenals have to predominate, a lower, more animal and less self-controlled type of mentality is produced.

In direct contrast to the subthyroid types is he who originally was hyperthyroid.  During childhood he is quite healthy, thin, but striking robust, active, energetic, generally fair-complexioned with nose straight and high bridged, eyes rather “poppy,” teeth excellent, regular, firm, white with a pearly translucent enamel.  These children are always on the go, never get tired, require little sleep.  Seldom will one of the classical children’s diseases strike them, measles perhaps, but no other.  Adolescence for them, however, is more apt to be stormy and episodic, adjustment to the new world of people and things is much more difficult, wanderlust is acute.  All an expression of cells keyed up, charged with energy that must flow somewhere or explode.

The ruddy live-wire, recognized everywhere as bubbling with vitality, the life of any group, the magnetic personality may, however, be shocked by some seismic event like the death of a father or mother, or the ruin of some cherished ambition.  A break in the balance of the other glands follows quickly and disablement and invalidism, which may cure itself after some years, remain stationary, or descend to the worst forms of thyroid deficiency.