

838 PETEK BASSOE 



has disappeared. He is convinced that the theory of associated pancreas 

 lesions (Forschbach and Sever in) in diabetic acromegalics does not hold 

 and believes that sugar regulation is controlled by a complicated physiolo- 

 gic mechanism in which liver, pancreas, nervous system and glands of in- 

 ternal secretion participate and a lesion of any one of these parts suffices 

 to produce glycosuria. It is of scientific interest that Levy and Boulud's 

 production of glycosuria. in dogs by intravenous injection of the cerebro- 

 spinal fluid of an acromegalic patient supports Gushing' s view that poste- 

 rior lobe secretion passes into this fluid. 5 Anders and Jameson collected 

 183 cases of hypophyseal disease with mention of the condition of the 

 urine, reported during the five years following Borchardt's report, 1909- 

 1913 inclusive. Glycosuria was present in 28 cases and 16 of these were 

 instances of acromegaly. There were 88 cases of acromegaly in the series, 

 hence 18.2 per cent with glycosuria. 



Other Metabolic Disturbances. In a general way, the metabolic stud- 

 ies so far reported have not yielded uniform results, and are difficult to 

 evaluate clinically as too little attention has been paid to the stage of the 

 disease at the time of study. Retention of calcium, 6 nitrogen, phosphorus 

 and magnesium was noted by Moraczewski ; of calcium, nitrogen, and phos- 

 phorus by Eclsall and Miller ; of calcium and magnesium by Franchini and 

 Giglioli ; of calcium, magnesium and phosphorus by Bergeim, Stewart and 

 Hawk. Falta and Nowaczynski in three cases found the elimination of 

 endogenous uric acid twice or more than twice that of normal persons. 

 II. Salomon found the basal metabolism increased in two robust male 

 patients, not increased in two women while Means found it lowered in his 

 case and ascribed this to the great weight of the enlarged bony structures, 

 bone, like fat, being an inert tissue and reducing the calories per kilogram. 



The blood is often found at necropsy to be increased in quantity. Both 

 polycythemia and slight anemia may occur. Relative lymphocytosis is 

 common (Falta; Steiger), as is slight eosinophilia (Gushing; Steiger). 

 Rarely normoblasts and myelocytes, attributable to alterations in the bone 

 marrow, are found (Franchini and Giglioli). 



The Genital System 



As has previously been pointed out there is in acromegaly an early 

 tendency to an exaggeration of the male secondary sexual characters, and 

 for those of the female to assume a male type, namely : increased and more 

 diffiuse growth of hair, involution of the breasts, and change of the pelvic 



Macobson lias recently restudied the problem and has reached the conclusion that 

 such secretion does not occur. Johns Hopk. Hosp. Bull., 1920, xxxi, 185. R. G. H. 



8 According to Blair Bell calcium retention is a masculine characteristic; hence 

 this feature is another example of the frequently emphasized tendency to exaggeration 

 of the male sexual characteristics. 





