298 THE DISEASES OF THE HYPOPHYSIS 



lating of temperature may under circumstances show an especial lability. 

 F. Frankl-Hochu'art has already pointed out the fact that in tumors of the 

 hypophysis without acromegaly sometimes hyperthermia occurs, dishing 

 further reports that the injection of glandular extract into hypophysioprivic 

 animals leads to an increase of temperature, while in normal animals this 

 increase after the injection never occurs. Gushing has used this " thermoreac- 

 tion" as a diagnostic aid, and assumes a state of hypophysial insufficiency 

 in all cases of pituitary disease in which the increase of temperature occurs 

 after the injection of 2 cc. of a 5 per cent, extract of the anterior lobe of the 

 ox hypophysis. 



Kahn and myself in studies on tetany have several times seen in the acute 

 stages, after the injection of 2-4 cc. of pituitrinum glandulare of Parke, 

 Davis 6* Co. that, as was shown especially actively in investigations on 

 respiratory metabolism, there occurred an increase of temperature to over 

 38. Lately Bernstein and myself instituted experiments on twenty indi- 

 viduals, some of whom were normal and some affected with various diseases, 

 injecting them subcutaneously with 2 cc. and eventually 10 cc. of the glandu- 

 lar extract. Never did there occur an increase of temperature. In one 

 case of very chronic acromegaly, the experiment was negative (case Ad, Ob- 

 servation XXIX). We saw, on the contrary, in case F, Observation 

 XL IV, which will later be reported in detail, no distinct action after the 

 injection of 4 cc., but later on repetition with 5 cc. twice an increase of 

 temperature of more than 2. 



I would not attempt an explanation of this remarkable phenomenon. 

 More extensive observations are necessary to establish the diagnostic 

 significance of the reaction. 



Almost regularly in hypophysial dystrophy are found alterations of the 

 blood picture. 



I have carried out investigations as to this point for years, at first in 

 collaboration with Dr. Bertelli, in a series of cases at the clinic. 



Through the kindness of Prof. v. Frankl-Hochwart, we were permit- 

 ted to examine some of the cases reported by him. I cite the following 

 observations: 



Observation XXXIX. W., twenty-six years old, typical case of hypophysial dystro- 

 phy. Examination of the blood in July, 1907. At that time diplopia, reduction of the 

 visual power, bitemporal hemianopsia ; since the nineteenth year of life no erections, and no 

 libido, genitalia infantile, pubic hair and axillary hair almost entirely absent. X-ray 

 shows widening of the sella turcica. 



Alimentary glycosuria (100 gm. dextrose), negative. 



Erythrocytes, 4,800.000. 



Leucocytes, 5600 



Hemoglobin, 7.5 g. 



Dec., 1907, operation by Prof. r. Eiselsberg, after which improvement of the power of 

 vision and of headache. 



