Nervous and mental diseases . f Horsley, Schlof-fer, Eiselberg, Kauavel, Halsted, and Cushing. Operation is indicated1 Brit. Med. Jour., April 9, 1899. 504 NEUROSES. in those cases which present marked symptoms of advancing braintumor, particularly optic neuritis, or beginning optic atrophy andthreatened blindness. It may also be undertaken to control the gen-eral acromegalic state, as already several operated cases are recorded inwhich there has been an actual recession of the bony and soft tissueenlargements. After hypophysectomy, the patients condition must bewatched and hypophysis feeding
Nervous and mental diseases . f Horsley, Schlof-fer, Eiselberg, Kauavel, Halsted, and Cushing. Operation is indicated1 Brit. Med. Jour., April 9, 1899. 504 NEUROSES. in those cases which present marked symptoms of advancing braintumor, particularly optic neuritis, or beginning optic atrophy andthreatened blindness. It may also be undertaken to control the gen-eral acromegalic state, as already several operated cases are recorded inwhich there has been an actual recession of the bony and soft tissueenlargements. After hypophysectomy, the patients condition must bewatched and hypophysis feeding employed if the cachexia of a hy-pophysism appears. ADIPOSITY AND GENITAL DYSTROPHY. The relations of the genitals to the pituitary are abundantly estab-lished by clinical observations and animal experiments. Amenorrhea infemale and impotence in the male subjects of acromegaly is a commonobservation. Some of the youthful giant cases never develop bulls and cocks show pituitary enlargement, and, on the other. Fig. 216.—z-Ray picture of normal sella turcica, marked +. hand, dogs subjected to partial excision of the hypophysis cerebri becomefat and asexual with atrophic genitals (dishing). Juvenile cases presenting general adiposity and undeveloped genitalshave been of occasional mention in literature, but Froehlich x first calledattention to their relation to pituitary disease. Marburg2 divides suchcases into three classes : (1) Simple adiposity, (2) adiposity with genitalatrophy, (3) simple genital atrophy. To these must be added (4) in-fantilism, or a simple lack of physical and sexual growth (Church3).Marburg further enunciated the formula that hyperfunction of the pitu-itary resulted in acromegaly ; hypofunction in general adiposity andgenital dystrophy, complete 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 only a p
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