862 HAKVEY G. BECK 



Raymond Vieussens (1705) reported the case of "Le Cardinal de 

 Bonsy", who died at the age of 72 from a tumor of the pituitary gland the 

 size of a Ren's egg; there was also softening of the brain. For eleven 

 years he suffered periodically with epileptiform seizures affecting the eyes, 

 lips and tongue. He developed amaurosis in the left eye and impairment 

 of memory, and died from an apoplectiform attack. 



A case of an inflammatory tumor of the pituitary, which also involved 

 the left lateral and middle fossae of the skull, occurring in a woman 38 

 years of age, was reported hy Leveque-Lasource (1808). The chief 

 symptoms were acute headache with vertigo, fatiguing sleep, "painful" 

 dreams, blindness in both eyes, stupor and eoma. The pituitary was twice 

 the normal size and contained numerous puriform foci of a fetid 

 odor. 



An interesting case of pituitary disease, especially from the stand- 

 point of treatment, is one studied by de Haen 1759-61 (cited by Rayer). 

 This was probably the earliest case reported in which amenorrhea was 

 associated with pituitary lesion. The patient was a girl 20 years old 

 with a history of amenorrhea for three months, habitual vomiting for 

 fourteen days and amaurosis; symptoms which disappeared after the ju- 

 dicious employment of purgatives. Later menstruation again ceased ; 

 vomiting and amaurosis reappeared ; and as purgatives did not relieve her 

 this time the actual cautery was applied to the left side of the head with 

 the result that she died in five days from symptoms of meningitis, which 

 the author attributed to the use of the cautery. The autopsy showed a 

 left-sided meningitis, and the vessels, especially those distributed to the 

 left hemisphere, contained a large quantity of air (probably gas bacillus 

 infection). The infundibulum was enlarged 8 or 9 lignes (2 cm.) in 

 diameter and contained pultaceous material and calcareous matter. This 

 lesion caused pressure on the chiasm. 



Other cases have appeared in literature prior to Mohr's but without 

 a description of obesity resembling the hypophyseal type. However, 

 symptoms of hypopituitarism are enumerated, including visual defects, 

 mental disturbances, amenorrhea, epileptic seizures, obesity, slow pulse, 

 stupor and coma. Obesity as a symptom was mentioned by Morgagni 

 in 1766; pituitary changes with epilepsy by Greding in 1781 and also 

 by Wcnzel in 1810, the latter attributing the origin of epilepsy to the 

 pituitary gland which he considered had a very important function. In 

 addition Wenzel called attention to the enlargement of the sella in pituitary 

 lesion. Rogowitsch (1886) noted hypertrophy of the pituitary after re- 

 moval of the thyroid. A great advance was made by the introduction 

 of X-ray as a means of diagnosis by Oppenheim in 1889. Kollarits (1905) 

 reported from the literature up to 1904 fifty-two cases without acromegaly 

 ten of which appeared after Frb'hlich(a) published his case (Touche '02, 

 Vassale '02, Carbone '02, Finkelnburg '02, Koster '02, Neuman '02, Ces- 



