Tandler and Grosz described failure of closure of the epiphyses in the skeleton of a eunuch (39) and subsequently in a 35-yr-old Ottoman eunuch who had been castrated at age 8 yr (12) Koch reported that thinning of the bones of the skull was evident by x-ray in all of the Skoptzy men examined and that kyphosis was common (Fig. 4) (13). Likewise, Wagenseil observed that 20 of the 31 Chinese eunuchs had kyphosis of the spine (Fig. 5) (1

. These observations appear to have been made before it was recognized that kyphosis is a manifestation of severe osteoporosis in women (40). In the Wagenseil study, men with kyphosis averaged 59 yr of age and had an average duration of castration of 42 yr, whereas the men who did not have kyphosis were slightly younger (average age, 54 yr) and had a slightly somewhat shorter average duration of castration (33 yr) (1

. Involvement of the spine is common in men with osteoporosis of various etiologies (41), and in view of the fact that bone mineral density decreases progressively with time after castration, particularly in the first few years (42), it is surprising that kyphosis was not even more common in the Chinese eunuchs and the Skoptzy.