Case treated by extract of pituitary; no appreciable result. Analogy between myxcedema and acromegaly suggesting the thyroid gland; rapid improvement. Caton Med. Jou•., Feb., '95).
Three eases of true aeromegaly treated with tabloids of the pituitary body of sheep. In the first ease the headache. which was, at times, exceedingly violent, diminished. and recurrence of the head ache coincided always with momentary cessation of the treatment ; in the second case the headache, pains in the limbs, and panesthesia of the hands diminished, and the tumefaction of the soft tissues was less. In the third case, a diabetic patient, DO results were obtained. Mari »eseo (Soe. MM. des Hop., Nov. S. '95).
De Cyon mentions a case of a child, 12 years of age, who suffered from acrome galy. Under influence of treatment by hypophysin continued during six or seven weeks the condition of the patient was much ameliorated; weight fell from to pounds, and circumfer ence of abdomen from to 3] inches. Headaches had diminished in intensity and in duration, pulse had become regu lar. and intelligence began to awaken. Lancereaux (La Sem. Med., Nov. 23, '98)• Case of acromegaly in a woman aged 42 years corresponding in all respects to the usual type of the disease. The em ployment of thyroid tabloids produced a persistent and decided improvement. Gibson (Edinburgh Med. Jour., Dec., '99).
Our knowledge of the fact that the pituitary body is usually enlarged in cases of acromegaly is sufficient evi dence that the gland is diseased and that administration of the dried pit uitary body is indicated as much as thyroid extract in cases of myxcedema. The pituitary body may be found en larged in other diseases than acre megaly, and this may be compared with goitre where it exists without Graves's disease. The observations were upon three cases. In the first there was lit tle or no general improvement, but when the drug was stopped the patient always requested that it be continued. In the second there was marked improvement which lasted over a year and a half ; during this time the patient only suf fered from headache once, and that was when the medicine was withdrawn for a day and a half. The third case was complicated by advanced renal disease and died suddenly from heart-failure, although he was considerably benefited by drug. The administration of pit
uitary body had little effect upon the first case, but the last two seemed to he considerably benefited in their sub jective symptoms. Kuh (Jour. Amer. Med. Assoc., Feb. 1, 1902).
ACTINOMYCOSIS.—Gr., a ray; t.dxn;, fungus.
Definition. — A parasitic, infectious, and inoculable disease due to the de velopment of the actinomyces, or ray fungus. First described in 1877 in cattle by Bollinger and in man by James Israel; it can no longer be considered a rare disease. From its frequent develop ment in the lungs it has often been con fused with tuberculosis.
Symptoms. — The symptoms vary ac cording to the locality of the disease.
The affection is chronic and exception ally rapid. The granulation tissue is abundant and the mass resembles a tumor. Previous to suppuration it is quite firm, and, if progressing rapidly, is surrounded by diffuse oedema. Pain and tenderness hardly ever exist. When suppuration occurs the mass increases rapidly in size.
Total of 500 cases from literature showing that the various regions of the body are proportionately the site of the disease, as follows: Head and neck, 55 per cent.: thorax and lungs. 20 per cent.; abdomen, 20 per cent.; other parts. 5 per cent. In France the face and neck were affected in 85 per cent. of the 66 cases reported. Poncet and Bfrard (Le Bull. MOd.. Aug. 8, '97).
Mammary actinomycosis may occur in two ways: primary and secondary. In the former infection occurs either from propagation of the actinomycotic grains in the milk-ducts or from their penetration into the tissues through a continuity of the skin. Four cases of the primary form witnessed. The see (indary form spreads to the from the lung (most frequently) or sonic other organ. The disease is not easy of diagnosis, and is liable to be confused with tubercle, cancer. inter stitial inflammation, or syphilitic dis ease; and repeated microscopical exam ination of discharges or pieces of tissue should be made. The prognosis in the primary form is good. but in the second ary form unfavorable. Mileff (Gaz. gl. Hop.. Jan. 1, 1901).