. Endocrinology. ng with the development of eye symptoms thei-eappeared tachycardia, gastrointestinal irritability as evidenced byattacks of vomiting and a tendency to diarrhea, and an overwhelminglassitude in spite of her extreme restlessness and emotional excita-bility. She complained at times of pains in the back, hips and pulse ranged from 110 in the early morning to 140 at was frequent desire to urinate; sphincter control was was not sound nor restful. Vomiting attacks occurred fre-quently—on the slightest provocation. These attacks were asso-ciated with
. Endocrinology. ng with the development of eye symptoms thei-eappeared tachycardia, gastrointestinal irritability as evidenced byattacks of vomiting and a tendency to diarrhea, and an overwhelminglassitude in spite of her extreme restlessness and emotional excita-bility. She complained at times of pains in the back, hips and pulse ranged from 110 in the early morning to 140 at was frequent desire to urinate; sphincter control was was not sound nor restful. Vomiting attacks occurred fre-quently—on the slightest provocation. These attacks were asso-ciated with yellowing of the skin and marked dehydration. There wasmarked nocturnal diaphoresis at times. Physical Findings: The patient is 44% inches in height, 36pounds in weight and is poorly nourished. Her skin is moist and offine texture. Her blood pressure is 90/45; pulse, 148 lying down;buccal temperature, 99°F. She has an abundant head of hair, dark, offine texture, and with moderately low anterior attachment. The. eyebrows and lashes are well formed; hair is absent on the remainderof the body. The eyes markedly protrude. The sclera show abovethe cornea when the patient looks straight ahead; there is markedwidening of the palpebral fissures (Dalrymple and Stellwags sign),and weakness of convergence without diplopia (Mobius sign) ; invol-untary blinking is infrequent (v. Stellwags sign) ; other eye symp-toms are hippus, large pupils, dryness of the eyes, inability of theupper eyelids to follow the descent of the eyeball (v. Graefes sign),fullness of both upper and lower lids, pale conjunctivae, no tremor ofthe lids nor nystagmus of the orbs. The lids can be forcibly closedover the cornea; pressure on the orbit slightly accentuates the pulse;pupillary reflexes to light and distance arc lively. The ears are large and set at a wide angle to the head. There istenderness over the mastoids. The cervical and inguinal glands are WHKELON 439 palpable; the tonsillar fossae are empty; becau
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectendocrinology, bookye
