DIABETES INSIPIDUS 



873 



on the work of Motzfeldt whose experiments indicate that the posterior 

 lobe extract has not the diuretic properties attributed to it by physiologists 

 and on the results of his own surgical experience. He has had a number 

 of cases in which the syndrome of diabetes insipidus has appeared after 

 pituitary operation and in which he thinks 'other brain areas were not 

 injured. He also has had cases in which it has been possible to remove 



Third 

 ventricle 



MammiHary 

 body 



-Optic 

 chiasm 



\-7nfun- 



diiulum 



Medulla \ 

 oblongata ' 



fourth 

 ventricle 



^Hypophysis 

 -Post, lobe 



^Ant. lobe 



er cnereum 

 Oculomotor nerre 



Fig. 5. Diagram of vertical section of brain in region of hypophysis. Lesions at 

 indicated points produce the following physiological and anatomical results: 



a. Bernard's piquire. Glycosuria. 



b. Eye palsies and double vision. 



c. Polyuria and polydipsia (Camus and Roussy). 



d. Polyuria and polydipsia (Gushing, Motzfeldt and others). 



e. Dystrophies of body growth, giantism partial or complete; abnormal 

 depositions of fat (Froelich) ; defective development or disturbance of func- 

 tion of sex glands and secondary sex characteristics. 



f. Scotoma, hemianopsia, hemiachromatopsia, primary optic atrophy. 



completely suprasellar congenital tumors associated with diabetes in- 

 sipidus and in which the polyuria subsequently was not modified. 



The explanation of extreme thirst and excessive urination in diabetes 

 insipidus was shrouded in much mystery until experimental work on the 

 hypophysis and contiguous brain areas made clear that the disturbed 

 function was purely a secondary phenomenon. Finkelenberg expressed 

 the opinion that there are cases of primary polyuria with organic brain 

 disease in which the ability of the kidneys to concentrate urine is not dis- 

 turbed to any degree. In such cases there is a noticeable dependence of the 

 quantity of urine upon the character of the food which acts as an abnormal 



