896 



WALTEK TIMME 



f ests itself ; headaches, pituitary in character come on ; there is drowsiness ; 

 acromegalic beginnings or other pituitary stigmata may be seen; the 

 fatiguability may continue or lessen; there are mental confusion and 

 hebetude ; epileptiform attacks may occur, uncinate in type ; the sella tur- 

 cica enlarges or else erosin of sella or clinoids takes place ; the blood sugar 



Fig. 3. Shows thymic enlargement. Arrows point to margin of thymic shadows. 



gradually increases if a cure is established. In uncompensated cases men- 

 tal symptoms, moral and intellectual deficiencies and delinquencies arise. 



Fourth Stage. Either complete compensation is reached, so that the 

 patient may live comfortably within limits of exertion, or else the condi- 

 tion may progress to the end of life as a pituitary case. The various 

 external manifestations of pituitary disturbance remain even if the physio- 

 logic cure is complete. The blood pressure rises; the headaches cease; the 

 fatiguability vanishes. 



Discussion of Symptomatology. The bony structure in the first and 

 second stages usually shows anomalies in proportionate skeletal growth, 



