244 



THE DISEASES OF THE HYPOPHYSIS 



trunk has become essentially stronger. Number of collar formerly 41, now 46. For two 

 or three years on every psychical excitement, and less on every bodily movement, in- 

 stantaneous occurrence of outbreaks of sweats; potency not entirely normal since the age of 

 twenty, since the beginning of the disease rapid diminution of libido, and now it is lost 

 utterly. Appetite increases at times. In 1910 thyroidin administered at home; this led to 

 palpitations of the heart, that have persisted to the present. Thyroidin also acted unfavorably 

 on the sweats. A cousin of his father's also suffered from acromegaly. For six or seven 

 months headaches on the vertex and occiput. Power of attention has considerably 

 decreased. Often cramps of the musculature of the feet, and calves, and sticking pains 

 in the bones of the hands and feet. 



FIG. 38. Case of acromegaly (Observation XXV). 



Moderately compact body build. Head enormously big. Orbital margins protrude. 

 Root of nose very much broadened. Nose very thick, lower jaw extraordinarily massive. 

 Lower row of teeth about 2 cm. forward; the teeth of the lower jaw stand far apart from 

 one another. The color of the face is pale. Hair of the head dense and turns gray easily. 

 Circumference of the skull 62.5 cm. Circumference of the neck 45 cm., larynx enlarged. 

 Thyroid gland not enlarged. Enormous growth of hair on thorax. Circumference of the 

 thorax 107 cm. on inspiration, 97 cm. on expiration. Large erectile nipples. 



Pulse 56. Extremities enormously thickened in the distal parts. 



For example: Circumference of each thumb 8.5 cm., circumference of middle finger 

 8.5 cm. 



