"120 JOHN T. HALSEY 



Dystrophy Adiposogenitalis and Pituitary Obesity. In dystrophia 

 adiposogenitalis and pituitary obesity (which by many are consid- 

 ered to be due chiefly or entirely to hypofunction of the pars an- 

 terior, although Gushing and others believe that in their case there is 

 also hypofunction of the pars posterior), pituitary therapy has been em- 

 ployed with some success, which may be looked upon as at least in part 

 resulting from an organotherapeutic action of the pars anterior. Un- 

 fortunately in the majority of the cases reported in the literature prepara- 

 tions of the whole gland have been used. Although pituitary therapy has 

 often proven unsuccessful in these cases, favorable results from such treat- 

 ment have been reported by a number of clinicians. 



Von Cyon appears to have been the first to obtain favorable results from 

 administration of pituitary substance to a case of this type, incorrectly 

 diagnosed by him as acromegaly. Gushing (~b) in certain of his cases ob- 

 tained results varying from slight to marked amelioration. Beck reports 

 twelve cases in which administration of anterior or whole pituitary sub- 

 stance, usually combined with thyroid and sometimes with ovarian extract, 

 caused a redistribution of the fat and an increase in the function of the 

 sex glands besides a correction of some of the anomalies due to hypoplasia 

 of the genitalia. 37 Engelbach (in William T ice's "System of Medicine"- 

 in preparation and in a personal communciatioii to the author) has fre- 

 quently seen strikingly beneficial results from the administration of 

 anterior pituitary substance either alone or combined with posterior 

 pituitary substance to patients presenting signs of deficiency of the an- 

 terior lobe, or of both lobes. In such cases Engelbach has occasionally 

 obtained effects from the oral administration of these substances; but he 

 believes that when thus administered even in large doses (15 to 30 grains) 

 they are not particularly effective. From the hypodermic administration 

 of anterior pituitary preparations (such as antuitrin), he has obtained 

 strikingly beneficial results. The dosage depends on the degree of hypo- 

 function of the anterior lobe, the correct amount being determined by the 

 therapeutic effects, such as decreased muscular and mental fatigue, res- 

 toration of normal menstruation, return of libido, and development of a 

 general sense of well-being. For establishing the correct dose, Engelbach 

 has found that the therapeutic results have been of more value than either 

 basal metabolism determination or carbohydrate tolerance tests. In his 

 experience there have been no untoward effects from anterior lobe extracts 

 when given by subcutaneous, intramuscular, or intravenous injection. 



37 In view of ihe different opinions as to the role played in this disease by the 

 different portions of the pituitary some interest attaches to Dziembowski's report that 

 the daily injection of 1.1 c.cm. of hypophysin (that is, posterior pituitary) caused loss 

 of weight and return of litiido in a patient with dystrophia adiposogenitalis, who had 

 previously been treated without benefit by the administration of thyroid, suprarenal, 

 and testicular extracts. 



