HYPOPHYSIAL DYSTROPHY 2QI 



present have shown, that the limits of assimilation are raised (Bondi, cited 

 by v. Frankl-Hochwart; v. Noorden, and others). I here publish all of my own 

 observations of dystrophy, equally whether the diagnosis hypophysial dis- 

 turbance has made certain, or whether it is merely tentative. 



Observation L, XXXIII, alimentary glycosuria (100 gm.) negative. 



Observation Si, XXXIV, alimentary glycosuria (200 gm.) negative. 



Observation Si, XXXIV, after operation, alimentary glycosuria (100 gm.) distinct re- 

 duction. 



Observation Sch, XXXVII, alimentary glycosuria (100 gm. D) negative. 



Observation K, XXXVIII, alimentary glycosuria (100 gm. D) negative. 



Observation W, XXXIX, alimentary glycosuria (100 gm. D) negative. 



Observation P, XLIII, alimentary glycosuria (200 gm. D) negative. 



Observation F, XLIV, alimentary glycosuria (200 gm. D) negative. 



Observation G, XLV, alimentary glycosuria (200 gm. D) negative. 



Observation G, Wi., XXXVI, 'alimentary glycosuria (100 gm. D) negative, alimentary 

 glycosuria (200 gm. D) trace. 



Observation E. M., XXXV (200 gm. D) negative. 



From the observation on pertinent cases in the literature as well as the 

 cases here reported is elicited the fact that in hypophysial dystrophy there is 

 no inclination to glycosuria, but on the contrary an abnormal high tolerance for 

 carbohydrates. A single exception exists in the case of Link, a case of hypophy- 

 sial tumor without acromegaly and with diabetes. We shall simply state this 

 fact here and return to it in the discussion of the theory. 



Investigations as to the contents of sugar in the blood are up to the 

 present scarce. Gushing states that in certain cases he found an abnormally 

 low amount of sugar in the blood. Bernstein estimated the sugar in the blood 

 in two of the cases here reported. Both were certain cases, in one of which 

 (Observation S, XXXIV) the diagnosis was verified on operation, in the other 

 (Observation G, XLV) at autopsy. The values were 0.082 per cent, in case 

 S, 0.081 per cent, in case Gr, therefore normal. 



Investigations as to purin metabolism have as yet been carried out only 

 by Nowacznski and myself. 



In the one case the following was noted: 



Observation XXXV. E. M., forty-four years old. Entered clinic March 29, 1912. 

 Six years ago sustained a sprain of the lumbar spine by a blow from a stay. Present 

 disease began about six weeks ago with vomiting. Severe headache, twelve days ago 

 diplopia. Flickering before the eyes, weakness of vision. Patient is a heavy drinker; 

 no venereal diseases; for several months increase of weight, reduction of libido and 

 potency. 



Vigorous man, sensorium unimpaired, distinct abducens palsy of left eye. Left 

 palpebral fissure narrower than right. Left pupil wider than right. Pupillary reaction on 

 right prompt, on the left delayed. Diplopia on looking toward the left. Nystagmus of 

 left eye on looking toward left. Facialis normal. Tremor of the hands, otherwise no 

 motor or sensory disturbance. 



No ataxia. Reflexes normal. X-ray: Sella turcica itself is normal, but the clivus is. 

 atrophic as corresponds to the generally increased cerebral pressure. 



