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. Liq. 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- 



