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 Ibs. 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 Ibs. 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, 



