LIST OF ILLUSTRATIONS 



PAGE 



22. Approach to hypophysis by infranasal method 853 



23. Line of incision in fronto-orbital approach to hypophysis .... 854 



24. Adson's incision for approach to hypophysis through interior fossa . 855 



25. Exposure of hypophyseal tumor by intracranial method 856 



26. Placing the snare about the pedicle of the hypophysis tumo,r ... 857 



Dystrophia Adiposogenitalis 

 HARVEY G. BECK 



1. Case of Mrs. K, age 46 (Jan. 8, 1920). 



1. Partial atrophy of both optic discs, more marked in right eye. 



2. Central vision with correcting glasses. 



3. Marked nystagmus, chiefly vertical, slightly rotatory. 



4. Examination of the fields shows sharply divided bi-temporal 



hemiopia passing through point of fixation. 



5. X-ray; enlarged sella with symptoms of hypopituitarism. 



6. Diagnosis; hypophyseal mass with hypopituitarism of glandular 



portion. (Courtesy of Dr. Harry Friedenwald.) 



Sella normal in size and general outline 870 



Closed-in type of sella due to thickening of both anterior and posterior 



clinoid processes 871 



4. Closed-in, flattened sella, prolongation of anterior and posterior clinoid 



processes 871 



5. Slightly enlarged sella of normal variation 872 



<'. Case of acromegalia and gigantism with secondary hypopituitarism . 873 



7. Delayed epiphyseal union and tapering of the fingers 876 



S. Case of dystrophia adiposogenitalis in a girl 877 



!). (lenital hypoplasia in case of dvstrophia adiposogenitalis .... 878 



10. Dystrophia adiposogenitalis typus feminius age 16 years .... 881 



11. Showing irregularity and separation of teeth 882 



12. Showing fat dystrophy at end of two months 883 



13. Abnormally small closed-iii sella 884 



Ktfect of pituitrin on the excretion of urine in diabetes insipidus . . 885 



Dystrophia adiposogenitalis in a boy seventeen years of age . . . 886 



Ti. Pituitary hands 887 



17. Closed-in sella 888 



1 s . Comparison between epiphyseal lines of the pituitary and normal hand. 889 



Von Frohlich's case of hypophyseal obesity after operation . . . 892 



20. The pituitary hand. Note the gracile, tapering fingers 893 



21. Xornial female figure and outline 896 



Marked adiposity of the girdle type 897 



Familial tyne of hypophyseal obesity 898 



21. Trilateral dystrophy of fat in case of hypopituitarism 899 



Illustrating rase before and after treatment 913 



This figure represents the type of case in which fat is redistributed 



by administration of thyroid and pituitary therapy 920 



27. Chart of a patient suffering with hypophyseal dystrophy 921 



