ADENOLOGY. THE ENDOCRINOUS GI,ANDS AND THEIR EXTRACTS 285 



cient thyroid activity, which entails from my viewpoint, impaired ac- 

 tivity of all other ductless glands. In children we may have, also the 

 adipositas cerebralis of Frohlich, in which general obesity occurs with 

 defective development of the sexual organs and impaired intelligence — 

 due to deficient pituitary activity. Closely allied genetically with these 

 cases, are those showing the adiposogenital syndrome of Launois, very 

 similar to Frohlich's, but without impairment of intelhgence. The adipo- 

 sis dolorosa of Dercum, in which there is obesity, general or localized in 

 areas, with pain, spontaneous or paroxysmal, is also ascribed to impaired 

 activity of certain ductless glands. StiU another type, symmetrical lipo- 

 matosis, is characterized by the presence of masses of fat, often tender or 

 the seat of spontaneous pain, symmetrically in the axillae, groin, or other 

 regions, but oftenest about the neck. Finally, the obesity of pineal 

 deficiency may be mentioned as another example of the close relationship 

 between the ductless glands and obesity. 



Falling to the lot of the hemadenologist also are the abnormalities of 

 growth, several of which, even in individuals in apparent health, are mani- 

 festations, active, latent, or extinct, of some morbid process. In acro- 

 megaly for example, we may have general enlargement of the body, espe- 

 cially of the extremities and face; the lips, nose, and chin are more or 

 less prominent and. there is general increase of massiveness of the frame. 

 Individuals presenting such a type are not uncommon; in these, as well 

 as in certain very tail subjects, temporary lesions of the pituitary, 

 awakened by some acute febrile process, may have caused the acrome- 

 galic process to proceed far enough to provoke the appearance of its most 

 salient phenomena — all incapable of retrogression, after the causative 

 morbid process in the pituitary proper has disappeared. 



Resembling such cases at times are those of adrenal tumor, some of 

 which cause premature development so marked in rare instances that a 

 child of eight years may attain the size of an adult. ' The adipositas cere- 

 bralis of Frohlich and the adiposogenital syndrome of Launois also sug- 

 gestive of acromegaly in some cases, are deemed extremely rare because 

 the fully developed morbid process is alone taken as standard. Here and 

 there, however, the trained eye of the hemadenologist may discern the 

 stigmata of these disorders, and oppose, through compensative, regulative 

 or inhibitive measures, their evil trend. 



Stunted growth as clearly belongs to the domain of the hemadenologist. 

 This may follow, also irrespective of any other abnormal efiect, the infec- 

 tions of childhood, especially where the thyroid, thymus, and adrenals 

 had been the seat of lesions. In the complicated types there is, beside 

 the dwarfism of cretinism and its congerers, Mongolian and Loraine 

 nfantilism, the victim of achondroplasia, of fetal rickets; 



