62 THE INTERNAL SECRETIONS—1920 
The association of obesity and diabetes in its early 
stages is undoubtedly due to endocrine dysfunction. 
The mobilization of sugar seems to be under the control 
of several ductless glands, viz., the hypophysis and 
adrenals. Hyperglycemia or decreased glucose toler- 
ance, is a frequent finding in hyperthyroidism. These 
facts all indicate a close relationship between endocrine 
activity and the metabolism which concerns itself with 
the utilizatioin of fats and carbohydrates. 
The obesity of hypogenitalism, which is best illus- 
trated by the eunuch, is probably secondary to de- 
creased activity in glands other than the gonads—this 
lowered activity being part of a general endocrine 
hypofunction and the resulting cellular apathy. The 
obesity which is quite common in women after the 
menopause is also an expression of widespread endo- 
crine hypofunction accompanied by the lowered or lost 
ovarian activity. 
A CASE OF PITUITARY OBESITY 
The unquestioned part which the hypophysis plays 
in obesity is illustrated in the frequent association of 
pathologic changes in this gland in the cases showing 
the clinical syndrome of Frohlich as in the second case 
report: 
Mrs. W. M. D., 37 years old, weight 230 pounds. 
Complaint: Obesity and scanty menstruation; family 
history negative. The patient weighed 119 pounds 
When married at the age of 20; in six months her 
weight increased to 145 pounds; the menstrual flow 
was excessive at times, but has been getting more 
scanty of late years; she has never been pregnant 
though she has desired children. 
Examination showed a short woman, markedly obese, 
with heavy double chin and large abdominal panniculus 
of fat. There was an excessive growth of hair on the 
