Die Krankheiten der Endokrinen Drüsen

Transient Cushing Syndrome

“…Experimental evidence accumulated during past decades has established beyond doubt that the hypothalamus is specifically concerned in the pathogenesis of both abnormal weight gain and weight loss (Aschner, 1912;Camus andRoussy, 1913, 1920;Bailey and Bremer, 1921 ;Smith, 1927;Keller et al, 1936;Hetherington andRanson, 1939, 1940;Hetherington, 1940;Brobeck et al, 1943;Heinbecker et al, 1944). One of us (Zondek, 1925(Zondek, , 1926b reported cases of obesity of presumably hypothalamic origin, some of which were associated with a marked tendendy towards water and salt retention (water-salt obesity), which also was a dominant feature in the present case.…”

“…Spontaneous reversal or effective -treatment of Cushing's syndrome induced otherwise than by direct reduction of adrenocortical or pituitary hyperfunction has been occasionally reported. In our first case (Zondek, 1923), which was included by Cushing in his first publication of the syndrome (Cushing, 1932), sudden and intense weight loss became evident shortly before the patient succumbed to an intercurrent infection. In recent years we have observed a certain number of cases in which regression of the morbid phenomena occurred either spontaneously or as the result of dietary restrictions and/or dehydrative therapy, simulating thereby the excellent results achieved by drastic adrenocortical surgery.…”

“…Such reversibility of the disease process is in our opinion hardly compatible with the assumption of primary pituitary or adrenocortical pathology. In The fact that disorders in whose pathogenesis the pituitary is involved may result from hypothalamic as well as from primary pituitary malfunction (Zondek, 1924) is nowadays generally accepted. This also applies to Cushing's syndrome, an eventual hypothalamic origin of which has been postulated by several workers.…”

“…Although, as a rule-especially with polysymptomatic and rapidly developing cases-the seriousness of the prognosis cannot be doubted, the general validity of this drastic therapeutic viewpoint appears to us questionable. We have seen a number of cases-the first in 1923 (Zondek, 1923)-with a definite Cushing syndrome in which the signs and symptoms of the disease regressed either spontaneously or as the result of conservative measures. Clinical amelioration was in fact so striking that active therapy was again and again postponed, until it became superfluous.…”

Prednisone in the Induction of Ovulation

“…Four patients of our series, who suffered of m arked hirsutism , but had norm al 17-ketosteroid excretions in repeated exam inations, were considered as idiopathic, or with peripheric hypersensitivity of the hair follicle [18]. All previous therapeutical attem pts, including i.v.…”