MULTIGLAKDULAR SYNDROMES 911 



angina, a hypertrophied lower jaw, with difficulty in mastication and 

 deglutition. 



An article of extreme importance on account of the cure of the patient, 

 by Marina, describes a case of a girl of Sy 2 years of age, who had all the 

 signs of a beginning dystrophy with hypertrophic deltoids and gastroc- 

 nemii and such weakness in the shoulder girdle group that she could barely 

 lift her arms horizontally. He lost sight of her for five years and then she 

 appeared again entirely well. The author corresponded personally with 

 Erb in this matter, questioning him as to whether a patient with muscular 

 dystrophy had ever in his experience been cured, or whether he had ever 

 seen "formes frustes" of this disease. Erb replied that he had never seen a 

 single case of "forme fruste" they had all been progressive but that he 

 had seen one single case of cure in a young English girl. Erb and Marina 

 agreed that the cure in both of these cases was to be credited to the normal 

 evolution of the patient; presumably to the fact that following the be- 

 ginning of menstruation, normal development of the internal secretions 

 succeeded, a most pregnant idea in the light of our present knowledge of 

 the interrelation of the ovaries with the other endocrin glands. A fitting 

 companion piece to the above is the case of Levi and Rothschild of a myo- 

 pathic atrophy which showed considerable improvement on pituitary ex- 

 tract. 



Henri Claude in 1908 described a case of familial progressive mus- 

 cular dystrophy of rather different character from the usual in that the 

 patient had asymmetrical atrophies, more marked on the right side. Be- 

 sides the muscular condition, the bones on the right side were less de- 

 veloped than on the left, as shown by rontgenogram, and there were 

 vasomotor changes particularly evident in the right hand, with perspiration 

 and cyanosis. In cold weather the patient could not use this hand on ac- 

 count of the disability thereby occasioned. The temperature of the right 

 hand was constantly lower than the left and the sphygmomanometric 

 pressure was also less on the right side. Claude drew the conclusion from 

 these findings that the whole disease picture does not embrace merely the 

 muscular difficulty, but includes as well the central or peripheral nervous 

 systems. 



Jendrassik, after citing the cases of Marina and Erb, above mentioned, 

 in which a seemingly spontaneous cure had been accomplished in muscular 

 dystrophy coincident with adolescence, presents two somewhat similar 

 cases, of which the one was a true progressive dystrophy. The patient 

 was a girl who, just before puberty set in, had had the dystrophic process 

 cease, and then after menstruation had been established became entirely 

 cured, even to the return of the knee reflexes. There had been a precocious 

 body growth between the 10th and llth years, in which the breasts had 

 participated, growing to a mature size. 



Von Werdt describes a case with necropsy, which arose in a woman 



