ENDOCRINE ASPECTS OF OBESITY 63 



face and body. The fingers were short and spade-like. 

 The skin was quite moist and the hair oily. 



More extensive study and examination was impos- 

 sible in this case. The patient said "one doctor had 

 tried to reduce her with thyroid extract, but it made 

 her so nervous she had to discontinue its use." 



This case was thought to be one of adiposo-dystro- 

 phia genitalis, the reports of fat occurring particu- 

 larly in the locations described recently by Beck 7 . Here 

 we have illustrated the interrelation of several ductless 

 glands to produce the syndrome which varies in differ- 

 ent cases as one or other of the glands predominate. 

 This brings us to the third case report. 



Mr. J. D. H., white, male, and married, age 65 years ; 

 very large man ; entered hospital complaining of dizzy 

 spells for the three days preceding ; family history neg- 

 ative except father and mother were both inclined to 

 be obese; no brothers and sisters. 



Past history: Patient had always been obese, his 

 best weight was 367 pounds ; had taken the reduction 

 treatment when younger and lost 101 pounds in two 

 months; present weight, 330 pounds; history of in- 

 fluenza and rheumatism. At 40 years of age patient 

 was frightened in a railway accident. Two weeks later 

 his hair turned almost white, being formerly dark. 

 Systemic condition : Slight dyspnea on exertion ; appe- 

 tite has always been excessive; no constipation; noc- 

 turia four to five times a night; slept well until present 

 illness ; patient married but no offspring. 



Present illness : Patient seized with dizzy spells, ac- 

 companied by swimming sensations in the head; no 

 loss of consciousness ; haziness of vision and what pa- 

 tient describes as "butterflies" in the temporal fields ; 

 leukodermal spots for past 40 years. 



Physical examination shows very obese man; face 

 florid; there are some leukodermal patches on face 

 and neck; his hair i s snow white; eyes are negative, 



