444 PLURIGLANDULAR DISEASES 



amaurosis, pulse 66, improvement as a result of thyroidin medication. Autopsy. 

 Thyroid gland sclerosed, 12 gm., thymus large, suprarenals sclerosed. Genitalia 

 atrophic. Ovaries very small, sclerotic. Uterus infantile. Soft malignant, cystic de- 

 generated tumor of the hypophysis. 



Observation of Josserand. Man, thirty years old, five years ago influenza and articular 

 swellings, later great loss of body weight, marked weakness, the mustache fell out, also the 

 axillary hair and the eyebrows, the skin of the penis became thick, and inelastic, atrophy 

 of the testicles, loss of libido and of potency. Extreme weakness, then some improvement. 

 Anemia, senile appearance. Testicles the size of hazelnuts, bilateral hemianopsia, 

 apparent increase in size of the hands and feet. 



Josserand mentions in brief a second case who at the age of thirty-five passed safely 

 through an attack of influenza, and later became senile. 



Observation of Gougerot and Gy. Man, fifty-two years old, formerly very strong, very 

 potent, at the age of forty-one years a "hard to define" infectious disease, with pains in the 

 limbs and in the abdomen, vomiting and numbness, lasting two and a half months. 

 Later asthenia, and temporary polyuria. From this time on libido and potency gradu- 

 ally lessened and finally disappeared. Hairs of the beard fell out, axillary and pubic 

 hairs are almost entirely absent. Senile appearance, testicles atrophied, sensation of cold, 

 tuberculosis of the apices, lupus on the nose, erysipelas, later pneumonia. Autopsy: 

 Thyroid gland highly sclerosed, right lobe 6 gm., left lobe 5 gm. Testicles likewise 

 sclerosed, right 18 gm., left 20 gm. Suprarenals sclerosed, chiefly in the cortex; pancreas 

 also sclerosed, likewise the hypophysis (0.3 gm.), and the parathyroids. Also liver, spleen 

 and kidneys sclerotic. 



Personal Observation. Observation LIII. Forty-year-old man (history partly elicited 

 from the wife of the patient). Father of the patient died at the age of sixty years of 

 carcinoma of the stomach, mother at forty-five years, of tuberculosis. One brother also 

 died of tuberculosis, otherwise no tuberculosis in the family. One uncle died of diabetes. 

 No gout, no obesity, no Basedow's, in the family. The patient himself had in his youth 

 passed through measles and scarlet fever. At twenty years of age, catarrh of the pul- 

 monary apices, that became healed. The patient then remained healthy up to his 

 thirty-fifth year. Sexual life was fully normal. He married at the age of twenty-eight 

 years and has three healthy children. Hair of the head abundant, and there was a fair 

 amount of hair on the trunk and extremities. Abundant beard. Axillary and pubic 

 hair abundant. Potency and libido entirely normal. Had never engaged in [sexual] 

 excesses; at the age of twenty-two years gonorrhea and slight orchitis. He was never 

 especially strong muscularly, was always rather thin, but he felt well and could always 

 fulfill his now and then exacting duties as a tradesman. At the age of thirty-five years 

 he became ill rather acutely with fever, lancinating pains in the extremities, pains in 

 the back and neck (he cannot say whether the thyroid was swollen). The physician 

 diagnosed influenza and ordered aspirin. For some days later there also existed diarrhea. 

 The fever rose as high as 39.5C. Later when the acute manifestations had retrograded, 

 there occurred edema of the legs, the face, and also the backs of the hands and feet. 

 Albumin was found in urine and the physician diagnosed nephritis. The patient felt 

 very weak, after about eight weeks improvement occurred, but the weakness persisted; 

 convalescence continued for an unusually long time, for several weeks still the patient 

 suffered from great muscular weakness, he became thin, and the edematous swellings dis- 

 appeared very slowly. After three months the patient had recovered, yet he never felt 

 entirely well since that illness. The potency gradually became lost, and about three- 

 quarters of a year after the illness the testicles seemed to him to be smaller. Also the 

 penis was smaller, the hair of the head had become thinned out immediately after the ill- 

 ness, so that some bald spots had formed. Now also the hair of the mustache and 



