THE THYROID-OVARIAN SYNDROME 101 
gen retention; blood chemistry, serology and cytology 
negative; phenosulphonepthalein output normal. 
Case II. Male, 56 years of age, married, no children. 
Chief complaint, violent headaches coming on about 5 
A. M., lasting until about 2 P. M.; marked weakness 
and attacks of vertigo of intermittent character. Dur- 
ation of symptoms, 9 months. At present almost bed- 
ridden, because of weakness and uncertainty in gait. 
Physical examination shows that he is 20 lbs. over- 
weight. His blood pressure is 190 mm. systolic, and 90 
diastolic. Heart action is forcible, but there is no en- 
largement. There is no ocular error, and thermic 
tests of the semicircular canals show no abnormality. 
The skin is rather syanotic and dry, and the hair is 
brittle. 
Laboratory examinations: Urine, 1700 c.c. in 24 
hours; sp.gr., from 1015 to 1022; there is a faint trace 
of albumen and an occasional cast. Chemical examina- 
tion of the blood, Mosenthal test diet, and phenolsulpho- 
nepthalein test all fail to show evidence of kidney in- 
volvement. There is a mild secondary anemia. 
Case III. Male, aged 47 years, married, 3 children, 
alive and well. Chief complaint, vertigo, swelling of 
the lower limbs in the morning, itching of the skin at 
night. Duration of symptoms, eight months. 
Physical examination: 18 lbs. overweight (this 
extra weight has been gained in the past year); re- 
flexes very active; blood pressure, 185 systolic; eyes 
and ears normal. The heart is slightly enlarged, and 
there is a faint murmur at the aortic valve transmitted 
up into the vessels of the neck. There are numerous 
scratch marks and areas of pigmentation on the legs. 
Laboratory examination: Urine, 1900 c.c. in 24 
hours; sp.gr., varies from 1013 to 1030. Sugar present 
in amounts varying from one half to two and a half per 
cent., no acetone bodies. Blood chemistry and Mosen- 
thal test diet, as well as phenosulphonephthalein test, 
