SYMPTOMATOLOGY 331 



disappeared. The case was also described by Heubner. The case of v. 

 Frankl-Hochwart was that of a fi ve-and-one-half-year-old child, whose body 

 length corresponded to that of a nine-year-old boy; the development of the 

 penis and of the entire genitalia and the secondary sexual characters cor- 

 responded with those of a fifteen-year-old boy; frequently erections oc- 

 curred. The voice was deep, and in addition there was a premature mental 

 development (thoughts about the immortality of the soul); also Ostreich- 

 Slavyk designated the four-year-old boy described by him as "old- wise" 

 [altklug]. 



In most cases the conditions of nutrition were started to be very good. In 

 other cases apparently in those which develop later there occurred an 

 excessive adiposity. So for example is the case of O. Marburg; here we are 

 dealing with a nine-year-old girl, in whom 

 right at the beginning of the disease (eight 

 months ago) obesity developed, that finally 

 became excessive, especially on the breast 

 and abdomen. Autopsy showed a complex 

 tumor of the epiphysis consisting of tissue of 

 the pineal gland, the ependyma, the choroid 

 plexus, and of glia. In addition to this was 

 found a slight colloid thyroid gland struma, 

 and a slight status lymphaticus; the genital 

 glands and the hypophysis were normal. 



Also in the case recently described by Bailey 



J J ^ ternal genitalia ot a lour-and-one- 



and Jelli/e, that of a twelve-year-old boy, half-year-old boy, 123 cm. tall (penis 

 there was obesity; the genitalia were normal. 6 cm. long, hair on the mons 

 Autopsy showed a teratoma of the pineal y/ n f ris) ' accor * in c s * /'"'** 



Hochwart, Ztsch. f. Nervenh., 1900. 



gland. 



In the epiphysial tumors that up to the present have been observed in 

 adults and adolescents there occurred either no especial trophic manifesta- 

 tions (for example in the case of Neumann, twenty-seven-year-old man, or in 

 the case of Askanazy, nineteen-year-old man) or the trophic manifestions 

 were quite of a different kind. Here there occurred either adiposity, which, 

 as in M tiller's case may attain an excessive degree (increase of 55 to 79.5 

 kg. in weight) ; other cases of adiposity in pineal gland tumor or of tumors 

 that destroyed the pineal gland have been described by Coats, Daly, Falckson, 

 Kny, Konig, Nothnagel, and others. Or in other cases there develops a strik- 

 ing cachexia in which the skin may show a pasty consistency. In certain 

 cases polyuria has been observed, in others persistence of the thymus gland, 

 in the case of Neumann formation of a goiter. There may also occur atrophy 

 of the genitalia and of the mammae. 



The significance of all these trophic manifestations is not yet clear. As far as the pre- 

 mature development that occurs in childhood is concerned, the great morphological 



