870 



JOHN R. WILLIAMS 



temporal a marked quadrantal visual and color defect (see Figure No. 

 4). If it be true that ocular defects in diabetes insipidus are due to the 

 pressure on the chiasm, in this case the pressure must vary from, time 

 to time, indicated by the varying size of the color and visual fields. Con- 

 tinued pressure may cause destruction of some of the optic fibers evidenced 

 by the quadrantal defect in the temporal side of the left eye. Optic neuritis 

 and primary atrophy have been noted by some observers. 



Most cases of diabetes insipidus exhibit evidences of perversion of sex 

 gland function or maldevelopment of the genitals. In females, the men- 

 strual function will fail to appear in the young and it will cease in adults. 



L.E. 



R.E. 



30' 



Fig. 3. Case Mrs. W. Second observation five months later. Both visual and 

 color fields are very much contracted. 



Males are likely to become impotent. Similarly the genitals in both 

 sexes may remain infantile or become atrophic. Secondary sex char- 

 acteristics, as pubic hair and the beard, may fail to develop or disappear 

 when present. Such dystrophies as complete or partial giantism and ab- 

 normal deposition of body fat may also complicate the syndrome. This 

 phase of the subject is considered in detail elsewhere in this work, ac- 

 cordingly it will not here be further discussed. 



Sella Turcica. Since it has been believed that the hypophysis is in- 

 volved in the production of diabetes insipidus, clinicians have attempted 

 to gain information as to possible anatomical lesions in this structure 

 by X-ray examination of the sella turcica, because it is this bony cavity 

 which contains the hypophysis. Some writers, particularly Maranon, 

 have attached much importance to the size and shape of the sella as bear- 

 ing on the question of the lesion in the brain substance which it holds. 



