DISORDERS IN RELATION TO THE EYE 793 



on record in which, after amblyopia had been present for some time, vision 

 was raised to 7/15 by the administration of pituitary extract (hypoph- 

 ysin). Acromegaly and gigantism are hyperpituitary in origin and 

 the characteristic facies as well as coincident disturbances of vision are 

 manifestly dependent on changes in the region of the sella turcica and 

 the consequent alteration of growth relations in the orbit. 



Cases of dyspituitarism with failing vision, down to loss of light per- 

 . ception, homonymous hemianopsia and marked general symptoms, extreme 

 pallor and weakness, drowsiness and severe headache have been restored to 

 normal by hypodermic injections of pituitrin, 1 c.c. daily, after oral ad- 

 ministration had failed to affect the symptoms and subtemporal decom- 

 pression produced only temporary relief (Elsberg, Krug) and pituitary 

 tumor has been successfully treated by administration of thyroid and 

 pituitary extract combined with mercurial inunctions in definitely non- 

 luetic patients (DeSchweinitz, How). Eason reports the case of a patient 

 who was practically blind, but recovered normal vision and nearly a full 

 field in one eye after thyroid feeding. The improvement had persisted 

 for nine years; the patient had to take small doses of thyroid from 

 time to time to prevent recurrence of blindness and headache. Elsberg. 

 says that operative procedures such as sellar decompression, partial ex- 

 cision by the transf rental route, etc., while not dangerous in experienced 

 hands, are only palliative in the majority of instances, and suggests that 

 in field defects of hypophyseal origin, if associated with evidences of 

 secretory deficiency or cyst formation, a thorough course of hypodermic 

 treatment with glandular extracts should precede any operative inter- 

 ference. 



In a similar case with increased drowsiness and headache and feeble- 

 ness in a female with hyperpituitary markings, notably of the hair and 

 teeth and orbits, Timme observed that corpus luteum, administered tenta- 

 tively because the constitutional symptoms and visual disturbances in- 

 creased with the onset of menstruation and during its term, regularly 

 caused an immediate aggravation of the condition. Thyroid, gr. %> alter- 

 nating with whole gland pituitary, gr. 1, daily, and adrenalin in 5-7 drop 

 doses, later whole gland suprarenal, gr. 2%, twice daily, by mouth, com- 

 pletely relieved the systemic symptoms and the visual fields returned to 

 normal, while vision remained but slightly affected, 20/40, as before. 



Vascular Disturbances. Ocular hemorrhages, notably retinal, are 

 prevalent at puberty. They were formerly classed as vicarious menstru- 

 ation. Now, generally attributed to tuberculosis, and indeed reacting, 

 usually, to diagnostic injections of tuberculin, with focal, local, and 

 general disturbances. Often with low blood pressure and indications of 

 dysthyroidism. Lack of calcium and disturbance of coagulation indi- 

 cated by beneficial effect on pulmonary hemorrhages of calcium chlorid 

 10 per cent, 5-10 c.c,, 2-5 X, q. d. HemoTrhage activation in thyroid 



