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An endocrine basis for slipping of the upper femoral epiphysis is suggested by the fact that the lesion is nearly always accompanied by abnormalities of growth which in themselves appear to he caused by an endocrine disorder. This is especially true of those patients from whom an inadequate history of injury can be obtained. The usual disturbance of growth is the adiposo-genital syndrome, a condition characterised by obesity and deficient gonadal development ; less commonly there is a history of very rapid growth, resulting in a tall, thin child (Key 1926). In the obese children there appears to be a low level of sex-hormone in the circulation ; while in the tall, thin children there seems to be an excessively high level of growth-hormone. Both growth-hormone and sex-hormone alter the rate of proliferation of the cartilage cells in the epiphysial plates, with consequent changes in the thickness of the plates and in the rate of skeletal growth. Anterior pituitary growth-hormone stimulates the proliferation of these cells directly, with increase in the thickness of the plates and VOL.