ACROMEGALY 243 



the sebaceous glands is increased (see below for information concerning 

 increased sweat secretion). 



The growth of hair on the head is often remarkably dense, and the individual 

 hairs are thick. In the course of the disease abnormal hair growth occurs 

 on the trunk and extremities, as may be seen in the following observation. 



Observation XXV. T., thirty-one years old, cobbler, entered the clinic Dec., 1911. 

 First admitted Nov. 16, 1905. Since 1903 gradual enlargement of the hands. All mili- 

 tary gloves were too small for him. Also face has become broader, nose and lips have 

 become larger, weight somewhat less. Headache, pigmentations of the skin, thyroid 

 slightly enlarged. Eye-grounds normal. No hemianopsia. Sella turcica uniformly 

 enlarged to the size of a cherry. The dorsum sellae thinned. The clinoid processes 

 pushed backward. Skeleton of the hands and feet show appreciable thickening of the 

 soft parts. 



Nov., 1907. Headache has become much more severe. The hairiness of the body 

 has increased markedy. The hairs are brittle. Marked hairiness of the genitalia, abnormal 

 hairiness of the abdomen and extremities. 



Arcus superciliares enormously developed. Nose enlarged. Lower jaw slightly 

 prognathous. Cushion-like ear lobules. Mustache bristly. Hairiness of the linea alba 

 very strong. Very deep wrinkle formation on forehead. Potency entirely normal. 



Sella turcica deepened three times more than is normal. Dorsum sellae much thinned 

 and elongated. 



Alimentary glycosuria negative. 



Dec., 1911. During the last year the hairiness has become even denser. . Libido is un- 

 altered, the potency has decreased slightly. Typical acromegalic alterations of the skeleton 

 and the soft parts, no tachycardia. Slight enlargement of the thyroid gland. 



Investigations of the Exchange of Gases (Dr. Bernstein). 



Per kg. of body weight 

 CO 2 O 2 RQ CO 2 O 2 



233.5 288.7 ' 0.809 



275-5 342.o 0.753 2.733 3.55 



266.7 329.8 0.748 



Alimentary glycosuria strongly positive (0.78 gm. dextrose) 



Erythrocytes, 4,490,000 



Hemoglobin, 95 per cent. 



Leucocytes, 4900, of which: 



Polymorphonuclear neutrophiles, 56.7 per cent. 



Lymphocytes, 30.5 per cent. 



Large mononuclears, 12.6 per cent. 



Eosinophiles, 0.2 per cent. 



Investigation of the elimination of uric acid on purin-free diet shows values between 

 0.72 and 0.97 gm. therefore is very appreciably increased. 



The following is an -additional example of abnormal hairiness in 

 acromegaly. 



Observation XXVI. I. Bo., thirty-one years, entered May, 1911. The sickness began 

 in 1905. First enlargement of the fingers, then, about simultaneously, enlargement of the 

 feet, the skull, the nose, the neck. In 1908 began enlargement of the lower jaw. Also 

 the ears became somewhat thickened. Since 1909 the forearms and the metatarsus, too, 

 have grown. Also the circumference of the chest has increased and the hairiness of the 



