CLINICAL ASPECTS OF ENDOCRINOLOGY 21 
nal operation, changes the entire aspect of the case 
with a more definite settling of the picture. Some few 
cases are reported and seen where an actual tissue 
change has taken place in some one or more of the endo- 
crine glands with a quantitative disorder. For exam- 
ple, a man of 59 years states that at the age of 32 he 
was infected with syphilis and treated with mercury 
for three years, and potassium iodide for seven years. 
Up to the age of forty his average weight was 150 
pounds, and he was considered quite well. At that age 
he developed an acute illness, characterized by severe 
headaches, dizziness, and blurring of vision. He had 
pains all over his body, lost weight and flesh rapidly. 
He had some temperature and a diarrhea. He was in 
bed ten weeks. When he gained his feet again he no- 
ticed a decided change in his facies and the color of his 
skin. During the next year his hair dropped from his 
armpits and there was a gradual subsidence of secon- 
dary sex characters with loss of sexual activity, both 
sympathetic and cordial. He began to gain, and his 
weight increased up to 200 pounds. During the last 
five years he has taken all the various glandular prod- 
ucts, alone and in combination, without any manifest 
change. His skin was rough, he complained of the cold, 
the skin of his hands and feet was thick and cracked, 
he never sweat. His hair was thin—he had little to 
shave upon his face—and he complained of muscular 
aches and pains. Last fall he was seen by the examiner. 
The Goetsch test was negative. Lig. Hypophysis 
(pituitrin) over a period of time seemed to have no 
actual effect. However, about eight months ago, he 
was given a 1/8 grain pilocarpine hydrochloride to test 
out his responsiveness through his sympathetic system. 
He sweat. The next week he felt much warmer, the 
coldness left his hands and feet; his bowels, which had 
always been constipated, moved freely. A change had 
undoubtedly taken place and it was followed by injec- 
