INTERRELATIONS 409 



extremities. The pain is sometimes spontaneous, sometimes 

 induced by manipulation. The new fatty tissue has a soft 

 feel, or there may be harder tumours. Haemorrhages from 

 mucous surfaces may be observed. The disease is chronic and 

 progressive. 



The morbid anatomy consists in an increase of fatty and 

 connective tissue and degenerative changes in nerves. The 

 thyroid has been found hard and calcareous. Dercum's 

 disease differs from other forms of obesity in its irregular dis- 

 tribution, in the presence of pain, and sometimes of impaired 

 sensibility. It differs from myxoedema in that face, hands, and 

 feet are not affected and in the absence of mental symptoms. 



Thyroid treatment is said to do good in some cases (Allbutt). 



Arachnodaciyly. 



Some seven or eight cases have foeen described under this 

 name, notably by Morvan and Poynton. The patients are 

 children with overgrowth of the long bones, phalanges, meta- 

 carpals and metatarsals. The growth of bone is out of pro- 

 portion to that of muscles and tendons ; so that contractures 

 are produced. 



It is possible that the condition may be due to some defect 

 in the organs of internal secretion. 



