910 HAKVEY G. BECK 



Prognosis 



The prognosis depends upon the character of the lesion producing 

 the syndrome of dystrophia adiposogenitalis. The outlook of patients suf- 

 fering with hypophyseal tumors is grave, even in those with benign 

 tumors. The operation itself is a formidable one and the death rate is 

 high, especially in the hands of inexperienced cranial surgeons, However, 

 favorable results are frequently obtained by operation, and the patients 

 are occasionally symptomatically cured. The course is relatively slow, and, 

 in some cases the symptoms may persist for a great many years. 



Frankl-Hochwart, basing the prognosis on the history of the duration 

 of the disease, states that of his 124 collected cases the course varied from 

 several weeks to twenty years or more. Fifty per cent gave a history of 

 from one to two years duration and sixty-one per cent less than three 

 years. 



In the milder types of the disease (aneoplastic forms) the prognosis 

 is more favorable. This is particularly true of cases which manifest their 

 first symptoms during the physiological epochs (puberty, pregnancy, par- 

 turition, menopause). The symptoms may subside spontaneously or be 

 relieved by organotherapy. 



The pluriglanclular forms with predominant pituitary deficiency are 

 also amenable to glandular therapy. Unless the syndrome is due to a 

 tumor of the pituitary gland or local pressure the prognosis unquestion- 

 ably is more favorable if the condition is recognized early and proper 

 treatment inaugurated. 



Treatment 



The treatment of dystrophia adiposogentalis may conveniently be de- 

 scribed under the following headings: (a) organotherapy, (b) irradia- 

 tion, (c) general measures diet, bath, exercise, massage, etc. (d) 

 surgical. 



Organotherapy. The advancement along the line of therapy in dis- 

 eases of the pituitary gland has kept pace with the progress made in the 

 study of its physiological activities and its symptomatic manifestations. 

 Treatment has become more rational and the indications for organotherapy 

 have been established on a more sound and scientific basis. Fundamentally 

 organotherapy is intended to supply the organism with normal gland sub- 

 stance containing the active principles necessary to physiological growth 

 development and metabolism. Hence it is in the deficiency syndrome that 

 this plan of treatment is most efficacious. In dystrophia adioposogenitalis 

 these include: 



