DYSTROPHIA ADIPOSOGENITALIS 893 



fingers taper; the nutrition of the nails is normal, although the crescents 

 at the base are often absent. There is also a marked change in the char- 

 acter and distribution of the hair with a tendency to hypotrichosis. The 

 axillary hair (hirci) and the pubic hair (crines pubis) are scant or ab- 

 sent, if the symptoms of the disease antedate puberty. The male may 

 not be able to grow a beard, and the upper outline of the pubic hair as- 

 sumes the horizontal form, the type met with in the female (typus femin- 

 inus). In the female, on the contrary, the distribution of hair may ap- 

 proach the masculine type. 



Sexual hypoplasia or the genital syndrome is a factor equally as im- 

 portant as obesity in typical dystrophia adiposogenitalis. In the pre- 



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



adolescent male the genitalia are rudimentary, including the penis, scrotum, 

 and testicles; the latter are usually partially descended or entirely un- 

 descended (criptorchidism). The secondary sex characters frequently 

 do not appear. This condition is generally associated with feminine char- 

 acteristics, especialy in regard to the distribution of the hair and deposits 

 of fat above referred to, in addition to occasional enlargement of the breast 

 and juvenile voice. Other signs of feminism are the skeletal features; 

 namely, gracile extremities, small hands and feet, tapering fingers, round 

 limbs, genu valgum and broad pelvis. In the adult male, whose genitalia 

 had been normally developed, the disease causes retrogressive changes 

 resulting in genital atrophy with impotence, absence of libido and ten- 

 dencies to feminism. 



In the female sexual infantilism occurs with hypoplasia of both ex- 

 ternal and internal genitalia with symptoms of frigidity, amenorrhea and 

 sterility. In conjunction with sexual infantilism and adiposity in young 

 individuals, dwarfism frequently occurs, due to skeletal undergrowth. 

 Falta(c) quotes cases in which growth was arrested at five (Goldstein), 



