HYPOPHYSIAL DYSTROPHY 299 



March, 1908: erythrocytes, 5,260,000 

 Leucocytes, 7500 

 Hemoglobin, 8.2 g. 



Observation XL. D., twenty-one-year-old man, Nov., 1909, for ten years gradually 

 occurring headaches and vomiting. For eight years, diminution of the visual acuity. 

 At that time temporal hemianopsia. Pronounced obesity, genitalia infantile, pubic and 

 axillary hairs absent. Destruction of the body of the sphenoid bone and of the dorsum 

 sellae. June, 1907, operation by Prof . v. Eiselsberg. Cyst of the hypophysis, histologically 

 carcinoma. Improvement of the power of vision. May, 1908, occurrence of erections. 

 August, 1908, voice deeper. October, 1909, sparse hairiness in the axillae and on the 

 pubes. Eye-findings as formerly. No erections. Body weight now 62% kg. (formerly 

 65.2 kg.). 



Blood count: Erythrocytes, 4,200,000 

 Hemoglobin, 9.4 gm. 

 Leucocytes, 8200 



Polymorphonuclear leucocytes, 52 per cent. 

 Large mononuclears, 7 per cent. 

 Lymphocytes, 37 per cent. 

 Eosinophiles, 4 per cent. 



Observation XLI. O. M., girl, twenty-three years old, Dec. 3, 1909. No hereditary 

 taint, always well, except that from childhood she has been strikingly pale. One menstrua- 

 tion at the age of twelve years, she mensturated regularly between the ages of fourteen 

 and nineteen yeais, then sudden cessation, with normal genitalia. Now and then mod- 

 erate pressure in the head. March, 1909, influenza, after which dietary treatment with- 

 out rest in bed. Increased in weight 8.5 kg. (from 53.5 to 62 kg.). At the beginning of 

 October, 1909, blurring before the left eye, since which time things have remained station- 

 ary. No headache, no vertigo, no vomiting, no fainting-spells, no insomnia, no yawning, 

 no disturbance of movements, no rhinorrhea. 



Eyes. 0. D. normal, O. S. 6/12 fundus normal, L. P. temp, scotoma for white. Bi- 

 temporal color hemianopsia. The nerve findings negative. Internal findings and urinary 

 findings negative. Moderate struma, patient is of medium height, strikingly pale, does 

 not make an impression of corpulency, except that a rather large collection of fat is present 

 on the abdomen. Hair of the head abundant, axillary and genital hairiness normal. The 

 fingers seem somewhat puffed up and thickened. Slight development of hair on the upper 

 lip and chin. 



X-ray (Decent Dr. Keinbock] : Sella turcica appreciably enlarged, especially below and 

 behind. The dorsum sellae is visible only as a small bolt-shadow strip. 



Weight 61 kg. Temperature on Dec. 6 and Dec. 7 varied between 36.2 and 36.7. 

 Blood count: Erythrocytes, 4,464,000 

 Hemoglobin (according to Sahli), 70 per cent. 

 Leucocytes, 5900 



Polymorphonuclear leucocytes, 60.8 per cent. 

 Lymphocytes, 30.8 per cent. 

 Large mononuclear, 4 per cent. 

 Eosinophiles, 4 per cent. 

 Mast-cells, 0.4 per cent. 



Observation XLII. K. L., seventeen years old. Dec., 1909. Up to this time has 

 not yet menstruated, since the autumn of 1906 headaches, decrease of visual power and 

 rapid increase of body weight. Bitemporal hemianopsia. Genitals infantile. Axil- 

 lary hair poorly developed. X-ray shows dilatation of the sella. 

 Operation by Prof. v. Eiselsberg. 



