64 THE INTERNAL SECRETIONS—1920 
except the temporal halves of the disc, which are pale; 
the visual fields show a right homonymous hemianopsia; 
chest negative. Heart: Sounds distant, faint, slow but 
regular; no murmurs heard; pulse, 60; blood pressure, 
systolic 182, diastolic 68; arteries showed some harden- 
ing; abdomen very thick and panniculus; no tender- 
ness; genitals negative. Extremities: Superficial 
veins dilated; slight pitting edema of legs; reflexes 
normal. Examination of skin of the body shows depig- 
mentation of all areas of over-flapping skin as panni- 
culus abdomen hangs over upper thighs. Some depig- 
mentated areas in axilla, surrounded by areas of 
marked pigmentation, sharply defined; axillary hair 
almost absent; pubic hair very scanty; no hair on fore- 
arms or legs; normal growth on head and face. X-ray 
shows very small and shallow sella turcica which was 
found to be normal] at autopsy. Blood Wasserman 
negative; urine negative; temperature normal. 
Patient continued to have dizzy spells at short inter- 
vals with total loss of consciousness, and involuntary 
passing of urine. The pulse became as low as 40 to 50 
per minute, with some premature systoles. A few days 
later patient was seized with a series of successive 
attacks, spastic in nature, with total loss of conscious- 
ness. His condition grew worse until death. At this 
time a clinical diagnosis of cerebral thrombosis was 
made, which later proved to be correct. 
An autopsy revealed arteriosclerosis, thrombosis of 
the basilar arteries, chronic pancreatitis, marked obe- 
sity, fatty degeneration generalized and testicular 
hypertrophy. The sella turcica was found to be nor- 
mal. Hypophysis was normal in both macroscopic and 
miscroscopic sections. The adrenals contained a great 
deal of fat and showed beginning softening of the cen- 
ter. 
