. Journal of radiology . was slightlystooping, his legs somewhatbowed, his head large and pyra-midal in shape with the apexdownward. The vessels of thescalp were tortuous and examination of eyes and earswas negative. The urinalysisshowed a small amount of albu-min. The YYassermann and spinalfluid reactions were negativeThe blood count showed no ab-normalitv and the basal metabolic PAGETS disease—carman and carrick rate was +14. The neurologicexamination showed nothing ofimportance, the summary being:ptosis of the right eyelid, contin-ual twitching from platysma toright orbiculari
. Journal of radiology . was slightlystooping, his legs somewhatbowed, his head large and pyra-midal in shape with the apexdownward. The vessels of thescalp were tortuous and examination of eyes and earswas negative. The urinalysisshowed a small amount of albu-min. The YYassermann and spinalfluid reactions were negativeThe blood count showed no ab-normalitv and the basal metabolic PAGETS disease—carman and carrick rate was +14. The neurologicexamination showed nothing ofimportance, the summary being:ptosis of the right eyelid, contin-ual twitching from platysma toright orbicularis ocnli, taste defec-tive, salt and sour being —3 onboth right and left sides, Rom-bergism, and sensory aphasia toslight degree. Mental and motorapraxia +1, +2, (gradations ona scale of 1 to 4). A tentativediagnosis of cortical lesion due tobony changes was made by theneurologists. The systolic bloodpressure was 120,, the diastolic Findin< disease of the head andthe left tibia (Fig. 11).. Fig-. XI.—Case 309410—Skull en-larged, inner table increased inthickness and density, outer tableincreased in thickness, irregularityand finely porous. Nodular areas ofbone scattered over the vertex. Case 11 (318460)Mr. G. H. P., aged 56, was ad-mitted to the Clinic June 24, 1920,complaining of pains in the patient had had rheumaticfever 20 years before and again infive years. When he was 26 hehad renal colic and passed a stone. He had had a fracture of the leftelbow ten years before and bothscapulae were fractured five yearslater. He had had a chancroid atthe age of 55. The patient first noticed a dullpainful aching in the right tibiaat night about three years before;it was relieved by rubbing. Eightweeks before examination he be-gan to have steady pain alongboth tibiae accompanied by swell-ing at the lower third of bothlegs. Bowing of the legs had beennoticed in the last three to fouryears and gradual enlargement ofthe head during the last five
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