Nervous and mental diseases . velop-mental periods of life, and progressive nature point to a lack of trophiccontrol. Putnam,2 accepting seven from Baumgartens list, has beenable to tabulate fifteen cases, including that of Edes. Morton Prince3believes that this condition is but a part of osteitis deformans, withwhich it is sometimes associated, and that both are of neuropathic 1 Amer. Jour. Med. Sciences, May, 1909. 2 Ibid., July, 1896. 3 Ibid., Nov., 1902. 508 NEUROSES. origin. In the majority the disease appears under thirty years ofage, and often in childhood or at puberty. The cranial enl
Nervous and mental diseases . velop-mental periods of life, and progressive nature point to a lack of trophiccontrol. Putnam,2 accepting seven from Baumgartens list, has beenable to tabulate fifteen cases, including that of Edes. Morton Prince3believes that this condition is but a part of osteitis deformans, withwhich it is sometimes associated, and that both are of neuropathic 1 Amer. Jour. Med. Sciences, May, 1909. 2 Ibid., July, 1896. 3 Ibid., Nov., 1902. 508 NEUROSES. origin. In the majority the disease appears under thirty years ofage, and often in childhood or at puberty. The cranial enlargementis sometimes preceded by inflammations about the head, such as erysip-elas, and by traumatism. Early symptoms have been headache, drow-siness, epileptic attacks, deafness, and blindness. Mental irritability orenfeeblement is common. Exophthalmos, loss of hearing, facial palsy,optic neuritis, and blindness are due to local or intracranial anterior portion of the head is usually most enlarged, and the upper. Fig. 219.—Hyperostosis cranii (Putnam). facial bones are more affected than the inferior maxilla. Prognathismis not commonly observed. There is usually a large increase in thebitemporal diameter. In some instances the bones are rather evenlyenlarged; in others there are numerous exostotic thickenings, both onthe outer and inner surface of the cranium, or on either aspect cervical vertebra? are sometimes also enlarged. The disease isprogressive and not amenable to treatment. Putnam, Starr, and othershave tried thyroids in vain. Encephalic pressure may in suitable casesbe relieved by trephining. Probably a number of different conditions havebeen grouped under this title. Some instances have shown unmistak-able pituitary disease. The bony enlargement of the head has beenassociated with persistent infantile conditions, and in later cases withsexual devolution. They may constitute aberrant links between moredistinct clinical types of excessive and
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