THE THYMUS GLAND 123 



rhages. Calf's thymus, rubbed down and prepared under sterile 

 conditions, produced negative results when injected into the peri- 

 toneum of control animals. 



Wiesel ascribes sudden death in the status thymicolym- 

 phaticus to a hypoplasia of the chromaffine system, as seen in the 

 post-mortem finding of changes in the suprarenals. He thinks that 

 the secretion of the chromaffine system, which raises blood- 

 pressure and stimulates the heart and the vessels, is supplied in 

 insufficient quantity, and that, in such individuals, slight noxae 

 may cause paralysis of the vessels and heart failure. 



It is evident, then, that sudden death in children and adults 

 as the result of laryngospastic convulsion, .as well as those cases 

 where death takes place at the commencement of chloroform 

 anaesthesia, the post-mortem findings frequently being negative, 

 are referable to a status thymicolymphaticus. The investigations 

 of Richter, as well as those of v. Sury, show, however, that great 

 caution should be exercised in identifying sudden death in child- 

 hood with mors thymica. Richter points out that an acute capil- 

 lary bronchitis, unrecognized during life, may easily be the cause 

 of sudden death. 



We have, as yet, no sufficient explanation of the pathogenetic 

 significance of the thymus in mors thymica, or of the manner in 

 which this is brought about. And the part played by the thymus 

 in the production of the so-called status thymicolymphaticus is 

 equally unexplained. 



Bartel recently interpreted the status thymicolymphaticus as 

 one of the symptoms of a more or less general hypoplastic constitu- 

 tion. He describes the post-mortem findings in over 100 

 cases. The superficial fascia was in all cases well developed; 

 the height was frequently above the average for the 

 sex and age; there was marked swelling and hyper- 

 plasia of the lymphatic glands, the lymphatic deposits 

 of the mucous membranes (tonsils, lymph follicles of the 

 tongue, stomach and intestines) and the follicles of the spleen ; the 

 bone marrow was frequently red, and there was, in the very large 

 majority of instances, a much enlarged thymus. The average 

 weight of the thymus considerably exceeded the average figures 

 given by Paitauf and Mettenheimer, namely : from 15 to 25 years 

 of age, 22.1 grm. ; from 25 to 35, 3.1 grm. Bartel's figures 

 do not differ greatly from those of Hammar, which are, however, 

 remarkably high. Bartel also found congenital smallness in the 

 lumen of the aorta and of the peripheral vessels, remarkable small- 

 ness in the size of the heart, comparatively large brain (hyper- 

 trophia cerebri), colloid degeneration of the thyroid gland and 

 fragile structure of the bones. The only details needed to com- 

 plete the clinical complex of the hypoplastic constitution are : 

 hypoplasia of the genitals, defective growth of pubic hair; in the 

 female, narrow vagina, infantile uterus, usually abnormally large 



