DWARFISM 



845 



hypophysis and of other ductless glands which he considers as merely part 

 of a disorder of the nature of a "discontinuous variation" of the human 

 species viewed from an anthropological standpoint, rather than as actual 

 causes of the growth disturbance. 



Hypophyseal Dwarfism. The first accurate description of dwarfs 

 of this class was made by Paltauf in 1891, and hence they are often 

 known as "Paltauf dwarfs." They are of normal size at birth but in 

 later childhood lag behind and soon their growth becomes almost imper- 

 ceptible. However, as the epiphyseal lines remain open even to old age 

 a slight growth continues. Thus, a dwarf 

 observed by Joachimsthal was 106 cm. tall 

 at 22 years and 128 cm. at 36 years. Peritz 

 (c) believes that the "inherent growth 

 tendency" existing at birth causes a person 

 to reach a height of 130-140 cm. but to 

 get beyond this hypophyseal activity is 

 necessary. He considers this form of 

 dwarfism the purest type of "formal in- 

 fantilism.-" In addition to the persistence 

 of the epiphyseal lines there is failure of 

 genital development, and psychic infantil- 

 ism also may be present. These dwarfs re>- 

 main children in body and mind and never 

 develop true adult characteristics but they 

 often live long enough to acquire senile fea- 

 tures. The latter may appear very early, 

 even in infancy or childhood, the com- 

 bination of infantilism and senilism being 

 designated "Progeria" by Gilford. The 



skin is particularly liable to assume a senile appearance at a relatively early 

 age (geroderma). Necropsies have shown destructive lesions of the 

 hypophysis, particularly its anterior lobe. Erdheim points out that hy- 

 pophyseal dwarfism results from a pure intrasellar lesion while associated 

 lesions of the base of the brain in cases of tumors growing beyond the sella 

 cause the additional feature of adipositas cerebralis to be present. Hence 

 the relationship to the Frohlich syndrome is a close one, and there are cases 

 possessing the features of both conditions, such as the one reported by 

 A. W. Hewlett. This patient (Fig. 3) was a man 27 years old, 4 feet 

 91/2 inches (146 cm.) tall and weighing 166i/ 2 pounds. He was very obese, 

 blind from optic atrophy, sexually infantile, and had diabetes insipidus. 

 He had no beard, and the mentality was childish. A woman, 27 years old, 

 obese, 121 cm. tall, proportionate, and said to have grown 6 cm. after the 

 age of 23 years is reported by E. J. Kraus. She never menstruated and 

 was an idiot. Necropsy revealed an exceedingly small hypophysis (0.16 



Fig. 2. Essential dwarfism. 

 After Levi, Nouv. Iconogr. de la 

 Salpetriere, 1910. 



