CLINICAL ASPECTS OF ENDOCRINOLOGY 19 
cutaneous blood vessels and the dermal system of invol- 
untary muscles (Gaskell®). Correspondingly, in the 
gastrointestinal tract are the secretory glands, the ex- 
tensive vascular supply and the unstriped or smooth 
muscle extending from the middle third of the esopha- 
gus to the internal sphincter of the rectum. Each part 
of this mucocutaneous system is under neurogenic 
control either through the sympathetic, the autonomic 
or the cerebrospinal nerves, and these govern, undoubt- 
edly, its biochemical and metabolic processes. Lang- 
ley, 7 Schoff* and Sherrington,’ have shown quite clearly 
the neurogenic control of the sweat glands, the erection 
of hairs, the phenomenon of “goose flesh,” in the skin; 
and the hypersecretory activity of the intestinal glands, 
as well as the peristaltic rhythm of the component parts 
of the alimentary canal. 
ENDOCRINE MANIFESTATIONS IN THE SKIN 
If one should consider the approach towards the de- 
velopment of a diseased or disordered endocrine gland, 
is it not of primary importance to determine the activ- 
ity of the sweat glands, the condition of the skin, the 
growth of hair, and such facts concerning the mucous 
membranes as can be seen? So characteristic are the 
signs manifest in the skin and mucous membrane 
accessories that the actual gland affected, either in its 
hyper- or hypoactivity, will depend upon the hyperidro- 
sis, the dryness or smoothness of the skin, the lack of 
hair or its anatomical distribution, etc. 
How often one will hastily diagnose a case as hyper- 
thyroid or hypopituitary upon the excessive sweating 
in the former and the unusual hair distribution in the 
latter, and yet, oftentimes neither will react to the pre- 
sumably indicated therapeutic measures. It is because 
of this tendency to enter the sphere of true quantita- 
tive disorders immediately that urges the writer to de- 
lay and emphasize these prequantitative types. For 
