MULTIPLE DUCTLESS GLANDULAR SCLEROSIS 443 



penetrate the cavity (hydrops ex vacuo), dura grown fast to the underlying tissue. 

 Destruction of the glandular lobe. Callous thickening in the retained part. Rigidity of 

 the fiber masses. 



Observation ofGouilloud. Woman, thirty-seven years old, mother of three children, se- 

 vere hemoptysis at the thirty-third year, at that time cessation of menses, which have 

 never been right since that time; the temperament, which was formerly very lively, has 

 altered, the patient is apathetic, forgetful, childish mentally. Cachexia for the last half 

 year. Face pale. Lashes have in part fallen out. Also the hair of the head is thinned 

 out and has lost its color. Also the hairs of the axilla? and on the pubis have fallen out. 

 The hands are cold, backs of the hands edematous. The thyroid is apparently smaller 

 than normal, the uterus entirely atrophic. Improvement by thyroid therapy doubtful. 



Observation of Djemil Pascha.- Man, eighteen years old, testicles began to atrophy 

 three years ago, the potency became lost. The mamillae began to increase in volume, also 

 the breasts became larger, the pitch of the voice was higher. After operative removal of 

 the breasts libido returned, the testicles became larger again, pollutions occurred; later, 

 increasing paleness and puffiness of the skin of the entire body, apathy, increasing cachexia, 

 dryness of the hair. Medication with thyroidin unsuccessful, death, no autopsy. 



Observation of Claude and Gougerot. Man, forty-seven years old, formerly very potent, 

 father of three children, alcoholism. At forty-two years, probably tetany, also perhaps 

 nephritis. During convalescence falling out of the hair of the head, the testicles atrophied, 

 complete impotence, the voice altered, and also the external genitalia became atrophic. 

 Hairs of the beard very scanty. Pubic hair and axillary hair absent. Skin dry, apathy, 

 pigmentations on the skin and mucous membranes, low blood-pressure, asthenia, gradual 

 diminution in the size of the thyroid gland, high-grade cachexia, tuberculosis of the lungs, 

 death. Autopsy showed tuberculous foci in lungs, liver and kidneys. The thyroid very 

 small, only 12 gm. The testicles very atrophic (22 gm.), prostate and seminal vesicles also 

 atrophic. Hypophysis small and sclerotic. Histological examination of the skin; atro- 

 phy of the epidermis; hair follicles, sweat glands and sebaceous glands atrophic. 



Observation of Gandy. Man, thirty-three years old, formerly gonorrhea, father of two 

 children; was very potent; at twenty-seven years, polyuria, headaches, severe sweats, 

 puffiness of the face, falling out of hair, nasal hydrorrhea. Later retrogression of the 

 secondary sexual characters and atrophy of the genitalia. Looks like an eighteen-year- 

 old youth. Skin of the face, pale, subicteric, skin dry, slightly scaly. Hairs of beard 

 very scanty. Trunk and extremities bald. Scrotum and testicles quite small, the latter 

 insensitive. Penis 6-7 cm. long. Complete impotence. Prostate also atrophied. Cre- 

 masteric reflexes absent. Perineum and genitalia have lost their pigment. Autopsy: 

 Inflammatory sclerosis of the thyroid (7 gm.), the testicles very small (8-10 gm.). In- 

 terstitial substance has disappeared entirely. Meningitic changes at the base of the 

 skull, with edema of the brain. No statement as to hypophysis. 



Observation of Brissaud and Bauer. Twenty-nine-year-old woman, heart failure, em- 

 bolism, tuberculosis, peritonitis. First menses at the age of fifteen. Birth of child at the 

 age of twenty. From that time has not menstruated. Infantile appearance, face very 

 pale, slightly swollen, breasts little developed. Hair of head dry and thinned out, likewise 

 the eyebrows, entire absence of pubic and axillary hair. Voice monotonous. Apathy, 

 headaches, anemia, and cachexia. Autopsy. Thyroid 15 gm. apparently normal. No 

 statement as to microscopical examination. Left side salpingitis and oophoritis. Right 

 ovary much sclerosed, very small. Uterus like that of a little girl. No statement as to 

 the pituitary. 



Observation of Sainton and Rathery. Woman, thirty-two years old, syphilis at the age 

 of twenty-five. Very distinct myxedema, appears very infantile, absence of pubic and ax- 

 illary hairs. Hair of head thinned out, dry. Apathy. Speech slow, almost complete 



