DYSTROPHIA ADIPOSOGElflTALIS 897 



abdomen. The predilection for fatty deposits in\these areas is one of the 

 most characteristic features of dystrophia adiposogenitalis. Upon careful 

 observation it is found in practically all cases whether the obesity is ex 

 cessive or slight in degree. Bernhard Mohr (1840) called attention to the 

 increase of fatty tissue in the heart, liver, and mesentery and <Biedl(c) 

 observed a remarkable deposition of fat in the omentum and retroperitoneal 



Fig. 22. Marked adiposity of the girdle type. Note increase in size of the hips 

 and lower extremities compared with the upper half of body. 



space. The fat never appears in the form of lipomas, and as a rule is not 

 tender as it is in Dercum's disease. 



In another group the deposits of fat assume a more general distribu- 

 tion, the mammae, shoulders, infra- and supraclavicular areas being in- 

 volved in addition to those mentioned. Occasionally a collar-like ac- 

 cumulation of fat appears on the neck and a cuff-like deposit on the 

 malleoli. However, the hands and arms, legs and feet generally remain 

 free. This form has been recognized as a familial type and presents a pic- 

 ture of obesity somewhat intermediate between thyroid deficiency and 

 hypophyseal deficiency, and is probably due to hypoplasia of the sex 

 glands secondary to hypopituitarism. Because of the close reciprocal 

 function between the pituitary, thyroid and gonads, true hypophyseal fat- 



