es are now thought to be only a syringomyelia. A recent case is
reported by Marie. In this connection it is interesting to notice a
case of what might be called acute symptomatic transitory
pseudoacromegaly, reported by Potovski: In an insane woman, and without
ascertainable cause, there appeared an enlargement of the ankles,
wrists, and shoulders, and later of the muscles, with superficial
trophic disturbances that gradually disappeared. The author excludes
syphilis, tuberculosis, rheumatism, gout, hemophilia, etc., and
considers it to have been a trophic affection of cerebral origin.
Cases of pneumonia osteoarthropathy simulating acromegaly have been
reported by Korn and Murray.

Megalocephaly, or as it was called by Virchow, leontiasis ossea, is due
to a hypertrophic process in the bones of the cranium. The cases
studied by Virchow were diffuse hyperostoses of the cranium. Starr
describes what he supposes to be a case of this disease, and proposes
the title megalocephaly as preferable to Virchow's term, because the
soft parts are also included in the hypertrophic process. A woman of
fifty-two, married but having no children, and of negative family
history, six years before the time of report showed the first symptoms
of the affection, which began with formication in the finger-tips. This
gradually extended to the shoulders, and was attended with some
uncertainty of tactile sense and clumsiness of movement, but actual
anesthesia had never been demonstrated. This numbness had not invaded
the trunk or lower extremities, although there was slight uncertainty
in the gait. There had been a slowly progressing enlargement of the
head, face, and neck, affecting the bone, skin, and subcutaneous
tissues, the first to the greatest degree. The circumference of the
neck was 16 inches; the horizontal circumference of the head was 24
inches; from ear to ear, over the vertex, 16 inches; and from the root
of the nose to the occipital protuberance, 16 inches. The cervical
vertebrae were involved, and the woman had lost five inches in height.
It may be mentioned here that Brissaud and Meige noticed the same loss
in height, only more pronounced, in a case of gigantism, the loss being
more than 15 inches. In Starr's case the tongue was normal and there
was no swelling of the thyroid.

Cretinism is an endemic disease among mountainous people who drink
largely of lime water, and is characterized by a condition of physical,
physiologic, a