Historical milestones in endocrinology

Abstract

The 1865 volume of the "II Morgagni", one of the most important Italian medical journals of the 19th century, presented two important articles, milestones for further scientific studies in the field of sexual differentiation. One was the original description of the "ramified cells" of testicular tubules by E. Sertoli, known today as Sertoli cells. The other was the first report and description of a patient with ambiguous genitalia, huge hyperplastic adrenal glands and salt-wasting symptoms: a true case of congenital adrenal hyperplasia, a disease well delineated only 80 yr later. Sertoli, although young (22 yr old) and inexperienced, was absolutely sure of his observation, also against the opinion of other important anatomists. He described different ways of presentation of these cells, hypothesized on their supportive and nutritive functions, but not on any endocrine function at that time. The second article was written by L. De Crecchio, a Professor of Forensic Medicine, and was the detailed description of the clinical, psychological and autoptic features of a female patient with severe ambiguous genitalia, who today would be diagnosed as having congenital adrenal hyperplasia probably due to 21-hydroxylase deficiency. This article gives, still today, important news on the clinical, psychological and social outcome of these patients before the possibility of therapy.