PSEUDOAOROMEGALIO SYRINGOMYELIA. —Affects usually the lower limbs only,— one only sometimes, and may not affect all the fingers. Deformities and trophic changes are present. Seoliosis and dis sociation of sensibility are notable feat ores.
Case of hereditary syphilis presenting great length of diaphysis of long bones, wrist, and elbow. Nobl (Le Bull. Med., Aug., '95).
disease usually begins between the ages of 20 and 40 years. It is more common in women than in men, and no influence can apparently be at tributed to race, heredity, or antecedents.
Case in a woman aged 63 years. Ganse (Deutsche med. Woch., Oct. 6, Case in a young negro aged 10 years. Bearan Rake (Brit. Med. Jour., Mar. 11, Cases of acromegaly in father and son. In the latter a tumor of the pituitary body was found at the autopsy, together with generalized endarteritis and scle rotic atrophy of the thyroid gland. Bonardi (Revue des Sci. Med. en France et h l'Etranger, Jan. 16, '94).
Case following excessive weakness due to parturition. Middleton (Glasgow Med. Jour., Aug., '95).
Case suggesting influence of trauma tism upon development of acromegaly and diabetes. Marinesco (Le Bull. Med., June 26. '951.
Pathology.—The skull may show dis appearance of sutures, hypertrophy of the external occipital protuberance, de formity of the condyles, thickening of the frontal and occipital bones, and in crease in size of the processes inside the skull and, above all, of the pituitary fossa. Both maxillaries are enlarged, the lower especially so; the alveolar processes and zygomatic arch are also increased in size.
Sciagraph from a case of Dr. Sanger Brown's. The skin outlines are entirely lost; pointed chin shows striking prog nathous type. The light area above the upper teeth is the antrum, distinctly bordered by an upper, bony plate. The outlines of the orbit are not shown. In normal cases the orbital arch shows itself almost as this region appears when a skull is viewed laterally. The frontal eminences protrude strongly. The light, semilunar area is not the frontal sinus, which often shows in sciagraphs, but is probably due to a more membranous bony formation• than the outside layers. O. L. Schmidt (Medicine, July, '97).
In the vertebral column the hyper trophy especially affects the extremities of the cervico-dorsal spinous processes. The hypertrophy especially affects the bones of the extremities and the extremi ties of the bones (Marie).
There is dilatation of the air-sinuses of the skull, and changes in the tempora maxillary articulation, permitting for ward dislocation of the lower jaw. There is a tendency to formation of new bone, both in normal and abnormal situations. Thompson (Jour. of Anat. and Phys., July, '90).
The most characteristic lesion is a symmetrical thickening, which increases toward the projections. Arnold (Bei triige z. path. Anat. u. z. Allge. Path.. B. 10, No. I).
Histologically the growth consists in an hypertrophy of the medullary bone, while the periosteal bone is reduced to a thin layer. This attacks red marrow bones especially. Duchesneau (These de Lyon, '91).
Case of a young man who entered the hospital for a tumor of the right thigh, requiring amputation of the limb. The tumor was a malignant ostcoid growth of J. Muller or chondrosarcoma of Virchow. The patient had recovered from the operation, which had been performed in December, 1894, when thoracic disturb ances and symptoms of acromegaly de veloped progressively. Death occurred toward the end of September, 1895. The lungs and pleurae contained enormous enchondromatous tumors, as large as a child's head in some cases; microscopic ally they were found to be everywhere composed of cartilage-tissue at every period of development.
The pathological lesions of acromegaly existed in the limbs; the hyperplasia of the periosteum, instead of being limited to the extremities of the phalanges, ex tended the entire length of the limbs to the hips. The shafts of the femur and humerus were surrounded throughout their entire length by osteophytes; on the ulna and radius some of the osteo phytes could still be compressed by the finger. The epiphyses were normal, but were, from the youth of the patient, not yen connected to the shaft. The condi tion of the pituitary body was not given in the autopsy. In its neighborhood, at the spheno-occipital synchondrosis, a myxomatous enchondrosis was found. R.