The abdomen was enlarged, appearing nearly as large as an ordinary pregnancy. The physiognomy was changed as you will notice in the picture. The features were coarse and broad, the face-lines having been obliterated by the swelling of skin and subcutaneous tissues, the lips were thick, nostrils broad and thick and the mouth enlarged. There was a painful slowness of thought, speech, and movement. When I asked her a

question she would look at me in a dull, listless way, and after several seconds she endeavored to answer in a slow hesitating manner, dragging her words. She could with considerable difficulty move about the room in a slow, unsteady manner, dragging the loins. She could not go up or down stairs, and very little exertion caused great exhaustion.

She complained of being cold all the time, even in the warmest weather in summer her temperature was slightly sub-normal. The heart was rapid and weak, but showed no organic change. The lungs, liver and spleen were apparently normal. The kidneys showed some disturbance with their function. Sp. gr., 1018, some albumen, some fatty, hyalin, and a few granular casts. Menstruation had been suspended for several years.

Blood examination showed the following: Hemoglobin 60%, red cells 3.362,500, white 5.450, polyneuclear's 74%, large lymphocytes 16%, small lymphocytes 10%.

No deformity of blood-cells was noted. Her appearance would indicate a weight of one hundred and seventy pounds to one hundred and eighty pounds.

A diagnosis of myxedema was made and treatment commenced immediately with thyroid extract. Burroughs, Wellcome and Co.'s tabloids were used exclusively. Beginning with a five grain tablet the dose was increased daily until the patient was taking forty grains per day without any apparent ill-effect.

The result of treatment was simply marvelous, inside of two weeks the improvement in the patient's condition

was noticed even by her family. This improvement continued steadily until at the end of ten or twelve weeks the patient's condition was nearly normal. The dry, rough, scaly, yellow skin had given way to a soft velvety pink. The hairy portions of the body were covered with a new growth of hair. The scalp and eyebrows were covered with a thick growth of hair which promised to become normal. The nails which were dry, rough, and thickened became smooth and shining. The swelling had entirely disappeared so that the face again resumed the normal expression. The voice was clear, the speech and intellect quick and active. The patient's weight was now one hundred and twenty-five pounds, the enlarged abdomen was reduced to normal, with entire absence of the prominent supra-clavicular pads. She began to take long walks and active exercise, and finally her physical and mental condition became perfectly normal.

There was such a complete change in her appearance in four months, that many of her friends who had not seen her during her treatment, failed to recognize her.

During the early part of March, six months after be ginning treatment we had reduced the quantity of "thyroid" to two tablets a day which seemed to be suf ficient to maintain the function of the atrophied gland.

I intended having her photograph at that time, but unfortunately postponed it for two yeks till I returned from my vacation. The day of my turn she was on the street, but feeling badly, consulted a physician who advised her to go to bed and prescribed for her. I saw her the same evening with all the symptoms of a severe pneumonia. Temperature 104 1-20, pulse 140. She died within eighteen hours, from lobar pneumonia. The photograph which I have presented you was copied from one taken just before her illness, which gives you a very fair idea of how she looked after recovery.