THE THYROID APPARATUS 75 



Certain French authors (Fere, Kaplin, and Fedoroff) are of 

 the opinion that this condition is an obesity due to hysteria, and 

 that the thyroid is without pathogenetic significance. 



The exhibition of thyroid gland in adiposis dolorosa has 

 occasionally been attended with success, but, in many cases, it 

 has been entirely without result. 



A special pathogenetic significance is ascribed to thyroid 

 insufficiency in the changes which occur in later life, and which 

 are included in the term cachexia of old age, or senile 

 degeneration. The foundation for the theory that old age results 

 from changes in the thyroid gland lies in the fact, commented upon 

 by Horsley, that in old age the thyroid becomes atrophied, its 

 follicles shrink and retrogressive changes take place in the 

 epithelial cells. This is reinforced by the fact that there is a 

 profound analogy between the signs of advanced old age and those 

 of myxoedema. The falling of the hair and the dropping out of 

 the teeth, the dry and wrinkled skin, the lowered temperature of 

 the body, the diminished perspiration, the indolent digestion and 

 consequent emaciation, the reduced metabolism and consequent 

 primary deposit of fat, followed by emaciation, the atrophy of 

 the sexual organs, the decrease of mental power, and the 

 diminution of the activity of the entire nervous system these are 

 all symptoms which characterize chronic myxoedema. Horsley 

 holds the view, which is even more emphatically expressed by 

 Vermehren, that senility is due, at any rate in part, to 

 degeneration of the thyroid gland, while myxoedema may be 

 described as a condition of premature senility. 



Premature decay, called progeria by Gilford, was regarded 

 by Rummo and his pupils as a separate clinical entity and was 

 described by them under the name of senilismus or geroderma 

 genitodistrofico. 



This condition is characterized by the appearance, in youth, 

 of senile changes in the skin and a defective development of the 

 sexual apparatus; it is believed to depend upon changes in the 

 thyroid gland and is regarded as a form of myxoedema frustrum. 



Lorand recently advanced the view that old age, or senile 

 involution, has an etiological relationship, not with the thyroid 

 only, but with all the organs which possess an internal secretory 

 function. He points out the similarity between the changes of 

 senile decay and the symptoms of myxoedema, and he lays par- 

 ticular stress upon the reduction of metabolism, the trophic 

 changes in the skin, the general increase of connective tissue, 

 and the cessation of sexual activity, all of which are symptoms 

 characteristic of both conditions. He believes that the atrophy 

 of the thyroid is the result of retrogressive changes in other 

 internal secretory organs (hypophysis, suprarenals). 



There is, however, one point in connection with this theory 

 which must not be overlooked. We have no proof that there is 



