898 



HARVEY G. BECK 



dystrophies are not very common; on the contrary the mixed or pluri- 

 glandular types are quite common. Thus, it is not unusual to find in the 

 same individual clinical evidence of hypothyroidism, hypopituitarism, and 

 hypogonadism in which the form of adiposity varies, according to the 

 relative degree of insufficiency of the respective glands. In a series of one 

 hundred cases of hypothyroidism studied by the writer, 20 per cent showed 

 evidence of hypophyseal fat dystrophy; whereas in a series of forty-six 



Fig. 23. Familial type of hypophyseal obesity. 



cases of dystrophia adiposogenitalis twenty-seven manifested symptoms 

 of hypothyroidism. Primary genital dystrophy, such as occurs in eu- 

 nuchoidism, closely resembles hypophyseal dystrophia adiposogentalis in 

 the distribution of fat (von Noorden). However, primary genital dys- 

 trophy without an hypophysea syndrome is relatively infrequent. When 

 it does occur it usually becomes early a mixed type in which hypophyseal 

 symptoms predominate. 



The source of glandular deficiency can sometimes be ascertained by 

 means of the cosmetic effect produced through localized deposition of fat 

 upon the configuration of the regional parts of the body. Thus the supra- 

 clavicular folds are indicative of thyroid deficiency; pads of fat about the 







