DWARFISM 847 



man. The postmortem findings, however, are related in great detail, with 

 measurements of every bone and organ in the body. The extremities were 

 of proportionate length. The thyroid and adrenals were very small, the 

 genitalia small and the parathyroids unusually small. The hypophysis 

 was attached to the brain by an infundibulum only 0.5 mm. thick. The 

 posterior lobe was not within the sella tureica but was lying at the base 

 of the brain, below and behind the-chiasma. A thin layer of glandular 

 tissue connected it with the intrasellar portion of the gland which was 

 converted into a thin-walled cyst. There was also another cyst which was 

 found to represent a dilatation of the persistent craniopharyngeal duct. 

 It is obvious, therefore, that a decided congenital malformation of the 

 hypophysis was present as well as extensive destruction of its glandular 

 elements. On aeount of these malformations the normally close connec- 

 tion between the anterior or glandular and the posterior or neural lobes 

 of the gland did not exist. Unlike most other cases of hypophyseal 

 dwarfism, a true tumor growth was not present. In this respect the case 

 resembles one reported by Simmonds in which the atrophy and cyst forma- 

 tion of the anterior lobe were attributed to an embolic process. All the 

 epiphyseal lines were found to be closed in Priesel's case, not surprising 

 in view of the advanced age. The genitalia were atrophic, yet infantile. 

 A case of dwarfism attributed chiefly to general infantilism is re- 

 ported by C. Sternberg. His patient was a boy 17 years old and 92 cm. 

 (36*4 inches) tall. There were no cases of anomalies of growth in the 

 family. H)e was said to have been of normal size at birth but curvature 

 of the spine and partial inhibition of growth were present from the age 

 of a year and a half. His intelligence was good. The cause of death 

 was tuberculous spondylitis. In spite of the resulting deformity of the 

 back, the case very properly is classified as one of true dwarfism rather 

 than of the false, disproportionate variety purely dependent on Pott's dis- 

 ease. The other bones were normal and all the epiphyseal lines wide open. 

 The appearance of the body was decidedly infantile. The genitalia were 

 small and there was no trace of beard, axillary or pubic hair. The thy- 

 roid, adrenals and hypophysis were abnormally small. The latter, how- 

 ever, as well as the adrenals were histologically normal. The thyroid 

 also showed little histologic change. The testicles showed changes which 

 were interpreted as due to defective development rather than to atrophy. 

 This fact, that the testicles were not atrophic but showed primary de- 

 fect of development, is interpreted in the sense that the dwarfism can- 

 not be attributed to hypophyseal deficiency which would have caused 

 atrophy of the testicles. The condition is looked upon as one of dwarfism 

 due to general infantilism and the group to which it belongs may be desig- 

 nated as hypoplastic dwarfism. This author described also a boy 20 years 

 old, 126 cm. (49% inches) tall, well proportioned but mentally defec- 

 tive and with definite thyroid deficiency while the hypophysis was nor- 



