ACROMEGALY 247 



cumanal and perineal hairs abundant. Also the leg is markedly covered with hair. Nose 

 and lips markedly thickened, lower jaw protrudes rather strongly. The incisor teeth of 

 the lower jaw are far apart from each other. Tongue very much more enlarged. Thy- 

 roid enlarged. Colostrum can be expressed from the breasts on light pressure. Eye-grounds 

 and field of vision normal. Lordosis of the lumbar spine. Enlargement of the nose and 

 lower jaw, hands, and feet. X-ray: Sella turcica much widened, as big as a crown piece. 

 The posterior clinoid process consumed. 



Dec. 3 100 gm. dextrose 3.58 gm. dextrose in urine. On a purin-free diet the values 

 of uric acid were 0.765, 0.720, 1.204, 1.296, "1.050, 1.097, 1.080, 0.762, 1.155, i-ou, 0.855. 



Blood examination erythrocytes, 4,975,000. 



Hemoglobin, 12 gm. 



Leucocytes 5600, of which: 



Polymorphonuclear neutrophiles, 76 per cent. 



Lymphocytes, 22 per cent. 



Eosinophiles, 2 per cent. 



FIG. 40. Case of acromegaly. 



Dec. 8 o.ooi gm. adrenalin subcutaneously. Pulse gradually rose from 72 to 102. 

 Blood-pressure from 95 to 115. After twenty minutes return to normal. Slight head- 

 ache, tremors, slight arrhythmia, considerable increase in diuresis, no sugar. 



Abundant carbohydrate diet leads to glycosuria. 



Dec. 14 o.ooi gm. adrenalin subcutaneously. Pulse from 72 to 96, blood-pressure 

 from 115 to 125, slight headache, slight arrhythmia, no sugar, diuresis from 950 to 2000. 



Dec. 15 i cc. pituitrinum infundibulare, marked diuresis, no sugar. 



Dec. 16 100 gm. dextrose, sugar strongly positive. 



Dec. 17 100 gm. dextrose, in urine 2.1 gm. dextrose. 



Dec. 21 o.oi gm. pilocarpine, moderate sweating, moderate flow of saliva. 



