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 



