916 



WALTEK TIMME 



infection such as measles, scarlet fever, variola, exogenous toxins, such 

 as lead apart from hereditary factors. Possibly the matter lies as with 

 tuberculosis, namely, that a predisposition exists which some efficient final 

 cause may awaken. Apart from the muscle atrophies, dystrophies, and 

 tendon contractures, many symptoms referable to the endocrin organs 

 are presented. These are brought out under "Types of the Disease." 

 There is an absence of signs referable to the spinal cord which separates 

 this group of disturbances from the spinal atrophies such as fibrillary 



twitching; or in the domain of the sensory 

 roots such as pain or dysassthesiaB of any 

 kind. There are no sphincteric disturb- 

 ances, at least until the final stages of the 

 condition are reached. The reflexes, those 

 that depend upon normally acting muscle 

 response to nerve impulse, are deficient or 

 absent in those joints served by atrophic or 

 diseased muscle groups. The bony develop 1 - 

 ment in many of the cases shows distinct 

 evidences of deficiency; the long bones es- 

 pecially, which upon rontgeiiographic exam- 

 ination are thin and slender but of normal 

 length. The blood picture is usually nega- 

 tive as to the number and character of the 

 cells, though the hemoglobin is frequently 

 depressed. But the chemical examination 

 is significant. The blood sugar content is 

 low, well below 0.080 per cent. There is 



present in the urine an abnormal presence 

 Fig. 16. Same patient as Fig. r . . ^ 



15. Note dyspituitary features, ol creatin. Kadioscopic examination oi the 

 Patient in condition of improve- skull frequently discloses a distinct pineal 

 ment due to glandular medica- , <y r 



tion. At first completely bed- shadow, especially noteworthy m adoles- 

 cents. 



Treatment. Upon the basis of the re- 

 cent findings of hypoglycemia, and a prob- 

 able pineal disturbance, combinations of or- 



ganotherapeutic agents have been used. These have for a basis the admin- 

 istration of pineal substance in increasingly large amounts over alternating 

 periods of time, from a week to a month, together with pituitary whole 

 gland and suprarenal whole gland feedings. The addition of a small 

 amount of thyroid regularly, perhaps as low a quantity as one-fiftieth of a 

 grain, accentuates the effect. Under combinations similar to those above 

 given, the author has had some twenty cases of progressive muscular dys- 

 trophy under treatment. He has not as yet formally reported his results, 



ridden with no ability to lift 



either arms or legs from bed 



level. Can now lift arms and 

 sit up in chair. 



