ADIPOSITAS DOLOROSA 581 



The suprarenals are microscopically normal. 



Also in the sexual glands is found nothing especial. The pancreas is macroscopically 

 normal. 



The microscopical examination of -the pancreas and the suprarenals showed fully nor- 

 mal conditions. The microscopical examination of the thyroid gland showed, as the 

 adjoining illustration shows, a colloid struma, yet there is still found every where abundant 

 thyroid glandular tissue of normal consistency (Fig. 98). 



Also the microscopical examination of the hypophysis showed normal relations, as well 

 in the glandular lobe as in the nervous lobe and in the pars intermedia. 



FIG. 101. Perivascular infiltration in a case of adipositas dolorosa (Observation LXX). 



Fig. 99 shows a general view. 



Fig. 100 shows a portion of the glandular part on higher magnification. 



Also another piece of fat tissue was examined microscopically; in this 

 section there was a perivascular infiltration, more distinctly developed about 

 the large vessels. See Fig. 101. 



Symptomatology. Adipositas dolorosa or adiposis dolorosa is found more 

 commonly in women than in men. It usually begins between the forty-fifth 

 and the sixtieth years of life. In women the disease often sets in with 

 the menopause. There are, however, individual cases in which the beginning 

 occurred at the eleventh year of life. As cardinal symptoms of the disease 

 are regarded the fat tumors, the tenderness of the fat to pressure or its pain- 

 fulness spontaneously (Dercum) , the asthenic and the psychical alterations 



