HYPOPHYSIAL DYSTROPHY 295 



haus found diabetes insipidus eleven times among fifty cases with bitemporal 

 hemianopsia. They themselves report a case of typical hemianopsia, which 

 eliminated 67 liters of urine with a specific gravity of 1002. Mercury and 

 iodine treatment brought about complete cure. 



I here report a case I saw a long time ago that in many respects is very 

 interesting. 



Observation XXXVII. A. Sch., fifteen years old. Entered the clinic Sept., 1909. 

 Father and mother well; no nervous affection in the family. The mother had had four 

 deliveries and three abortions. The first child is entirely well, the second is the patient. 

 The third and fourth children had had transitory illnesses that were without relevance 

 to the patient's condition. 



The patient has had a remarkably large head ever since birth. The first tooth ap- 

 peared in the sixth month, and he began to walk at the age of two years. At this time he 

 was remarkably tall a giant child. At three years of age there developed gradually 

 convergent strabismus that has existed up to the present time. The boy learned well at 

 school, and was even very intelligent and lively. From the age of twelve years there 

 developed a gradual lessening of visual power; vertigo often occurred, the boy had very great 

 thirst, had to drink very much and urinated very much. Also the statement is made by the 

 mother that at this time the boy had a remarkably large appetite. He also had to expecto- 

 rate very much. Gradual increase of body weight became apparent. 



In 1908 the patient had been at v. Neusser's clinic. There it was noted that there was 

 marked panniculus adiposis. Body weight 46.8 kg. Slight concomitant convergent 

 strabismus. The movements of the' eye-balls toward all directions are -very good, how- 

 ever. The penis is small, no pubic hair, patellar reflexes lively, temporal paleness of both 

 papilla. Field of vision normal. Amounts of urine between 2500 and 4500. Specific 

 gravity about 1008. 



According to mother's statement the emaciation began during the mentioned stay at 

 the clinic. Since that stay there have also existed severe headaches that occur about twice 

 weekly and are especially localized in the frontal region. During severe attacks there 

 exist marked sensation of heat and reddening of the skin of the face with outbreak of sweat, 

 vertigo and flickering before the eyes and mostly severe vomiting. Between these attacks 

 there exists great tendency to sleep, the boy sleeping twelve hours uninterruptedly. 

 According to the mother, there is a common inclination for yawning. The boy states 

 that now and then erections occur. The polyuria is now very considerable. It now is 

 as much as seventy-one times daily, and he must get up often at nights to urinate. 

 A ccording to the definite statement of the mother, the boy has not grown for a year. 



The boy is tall, the body shows the following measurements: 



Jugulum to ant. sup. spine, 38.5 cm. 

 Jugulum to symphysis, 46 cm. 

 Vertebra prominens to coccyx, 47 cm. 

 Circumference of chest, 72 cm. 

 Circumference of pelvis, 71 cm. 

 Upper extremities, 68 ,cm. 

 Lower extremities, 72 cm. 



The face has a more childish expression than corresponds to the age. The intelligence 

 is entirely normal, rather more mature than corresponds to the age. Hair is absent in the 

 axillae and on the pubes, also on the perineum. The boy is extremely emaciated, especially 

 on the extremities; the most fat is found on the outer surface of the thighs. The mons Veneris 



