872 



HAEVEY G. BECK 



study of this subject have been made by Fuchs, Erdheim(&), Jaugeas(a), 

 Kohler, Fisher, and Schiiller (the latter's treatise on Rontgen diagnosis of 

 the head, containing a complete bibliography, was recently translated into 

 English). By means of the character of sellar deformation Erdheim's 

 investigations made it possible to distinguish between intrasellar true 

 hypophyseal and extrasellar growths. In the former group the pituitary 

 fossa becomes enlarged in all diameters ; in the latter group in which the 

 tumors develop above the sella there is only widening to the entrance of 

 the fossa. However, both types are subject to variation in minor de- 



Fig. 5. Slightly enlarged sella of normal variation. (Rontgenogram by Dr. John 

 Evans.) 



tails, depend i no- upon the size, location, and direction in which the growth 

 proceeds. Erdheim states that acromegaly is most frequently associated 

 with the former lesion and dystrophia adiposogenitalis with the latter. 

 Ciishiiiiii 1) ) distinguishes three types of pathologically deformed and 

 enlarged sella\ 



1. Those associated with thickening of the clinoid processes 



and dorsiim ephippii. 



2. Those with thinning from pressure absorption of these parts. 



3. Those with more or less destruction of all outlines. 



In the first variety the enlargement is accompanied by thickening of the 

 walls. The typo is confined to the hyperpituitary cases and the bony 



