Nervous and mental diseases . plete pituitary defect in a severe cachexia anal-ogous to that after destruction or ablation of the thyroid. All thesejuvenile conditions are related to a lack or, in some instances, perhapsto ouly a perversion of pituitary control. Some of them present distinctsymptoms of a pituitary tumor, such as hemianopsia, cranial nerve pal-sies, and the diffuse symptoms of brain tumor, especially headaches,vomiting, and convulsions. The a?-ray plate (Figs. 216 and 217) often i Wien. klin. Kundsch., 1901. 2 Deutsch. Zeitschr. f. Nervenheilk., 1908. 3 Jour. Amer. Med. Assoc,
Nervous and mental diseases . plete pituitary defect in a severe cachexia anal-ogous to that after destruction or ablation of the thyroid. All thesejuvenile conditions are related to a lack or, in some instances, perhapsto ouly a perversion of pituitary control. Some of them present distinctsymptoms of a pituitary tumor, such as hemianopsia, cranial nerve pal-sies, and the diffuse symptoms of brain tumor, especially headaches,vomiting, and convulsions. The a?-ray plate (Figs. 216 and 217) often i Wien. klin. Kundsch., 1901. 2 Deutsch. Zeitschr. f. Nervenheilk., 1908. 3 Jour. Amer. Med. Assoc, 1910. GLANDULAR NEUROSES. 515 gives a vivid picture of excavation of the sella turcica. A pituitarytumor is not necessarily present. This gland may be compressed byan adjacent growth or influenced by a variety of pathological conditions arising after the attainment of full sexual growthcause, in varying degree, sexual inaptitude, genital atrophy, impotence,and amenorrhea, and may cause more or less Fig. 217.—x-Ray picture of sella turcica, marked +, excavated by pituitary tumor. No acro-megaly present. The treatment must be carefully individualized. Brain tumor con-ditions must be treated on their own surgical indications. Decom-pressive operations are advisable in some instances. AVhen the tumoris definitely limited to the pituitary, it offers an opportunity for abrilliant operation and an equally brilliant result. The cachexiaresulting upon a lack of pituitary function mu.^t be combated l)ypituitary feeding, and this may be tried in the infantile or juvenilecases. Adiposis Dolorosa.—In 1892 F. X. Dercum,^ under the titleAdiposis Dolorosa, d(>scril)ed a condition which seems in the adult to beanalogous to the adiposity and genital dystropiiy of Froehlich Avliichoccurs in earlier years. This condition has come to be generally knownas Dercums disease. In the etiology, neuropatliic heredity or a ])ors()nal neuropathic con-dition have not been n
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