286 



THE DISEASES OF THE HYPOPHYSIS 



listless and indifferent to all things that occur around her, she yawns very much, but 

 sleeps very little at night. According to her statement she sweats hardly at all. There 

 is no vomiting. As yet she has not menstruated. 



The patient is small, about 145. cm. The build of the bones is slender, the musculature 

 poorly developed, the layer of fat very abundant. Especially fat are the mammae, in 

 which no trace of glandular substance is palpable. The nipples are small and retracted. 

 Especial accumulations of fat are found on the hips, on the outer sides of the thighs, and on 

 the mons Veneris. The axilla as well as the mons Veneris possess only a very few hairs. 

 The genitalia are rudimentary. The labia minora are scarcely developed. The clitoris 

 is very short, hymen intact. The uterus very small, the ovaries are not felt. 





FIG. 51. Case of dystrophia adiposo-genitalis. FIG. 52. Hypophysial dystrophy. 



The patient shows great difficulty in thinking. She speaks German well enough it is 

 true, but responds to only very simple questions. In Russian she converses rather fluently. 

 She lies in bed very much, and is indifferent to her surroundings. During the examination 

 she yawned very much. 



The left eye is amaurotic, the pupils do not react although the consensual reaction is 

 present. On the right side is temporal hemianopsia and temporal hemianopic pupillary 

 reaction. Vision of O. D. i/io. Both papillae are sharply demarcated and atrophic. The 

 reflexes are normal. The neck is short, thick, the thyroid not palpable. The supra- 

 clavicular and infraclavicular fossa as well as the intercostal spaces are entirely obliterated 

 by the pads of fat. The abdominal walls are extremely fat. The fatty tissue of the skin 



