192 ENDOCRINE GLANDS 



CLINICAL SIGNS OF TUMORS OF THE PITUITARY. 



1. SYMPTOMS OF CRANIAL HYPERTENSION are present 

 in the majority of cases: severe headache, diffuse or 

 localized, frontal, retro orbital or bitemporal, with pain 

 or pressure over the eyes, when the headache is due to a 

 distension of the glandular capsule. Various neuralgias; 

 ocular, facial, or occipital; vertigo and vomiting of the 

 cerebral type. 



Certain symptoms seem peculiar to pituitary tumors. 

 They are: low body temperature ; it may go down to 34 

 or 33 centigrade and seems to have some relationship 

 with the neighborhood of the gland to the thermic centres; 

 sleepiness ; some patients have narcoleptic spells or become 

 torpid or indifferent; psychic disturbances are very fre- 

 quent, mystic delirium, persecution, depressive mania, 

 etc. 1 A certain number of insane in the past were 

 termed : amaurotic insane. 



%. OCULAR SYMPTOMS are those which we have 

 known for the longest time; they are the most common, 

 the most constant and the most important for the diag- 

 nosis of tumors of the pituitary or its neighborhood. 

 They are explained by the close relationship between the 

 pituitary and the optic tract. The latter can be injured 

 at the level of its three segments: pre-chiasmic, chias- 

 mic and retro-chiasmic. 



(a) A pre-chiasmic lesion results in visual disturb- 

 ances in the corresponding eye: narrowing of the visual 

 field, amblyopia, then amaurosis. According to the 

 nature of the tumor the amaurosis may come on rapidly 

 or at the end of several years. 



(6) A chiasmic lesion suppresses vision on the nasal 



1 It is believed that some of the unpleasant symptoms of the menopause are due to 

 pituitary disturbance probably a hyperseeretion relative to the secretion of the 

 thyroid and ovary which are undergoing more rapid retrogression. 



