22 THE INTERNAL SECRETIONS—1920 
tions of the posterior pituitary solution. Within a few 
weeks his skin became soft and moist, with some sweat- 
ing. His pains and aches left him; he said, “I feel 
looser.”’ He lost weight, and much of his accessory fat 
deposits disappeared. Not only could he mentally call 
forth an erection, but he often had spontaneous erec- 
tions. Might not the sympathetic stimulation have 
aroused some glandular activity, which is kept active 
by the injections? Or are these changes in the skin 
and vessel-activity only related to the vegetative sys- 
tem? 
A case of postoperative disorder, with the “settling” 
of symptoms, was seen in a woman of 38 years, who 
was always “nervous,” with indigestion, headaches, 
fatigue, and lack of ambition. Nothing seemed to give 
her relief. In October, 1919, she had a partial hys- 
terectomy for a fibroid without the removal of the ova- 
ries. For three months she improved physically, and 
then seemed to “slump,” not with indigestion, head- 
aches and “nervousness,” but with a predominance of 
vasomotor disturbances related to her gastrointestinal 
tract. She developed angioneurotic edema of the mu- 
cous membrane of the mouth and anal cutaneous junc- 
tion. Her mouth became filled with “canker,” small 
patches of erosion of the membrane. Her tongue be- 
came very red, cracked and swollen. Her color was 
changed, and became of a “muddy” appearance, with 
attacks of areal blushing. Her skin was dry, her hair 
fell out, and her face and hands would “puff” or swell. 
Are not these predominating symptoms vasomotor in 
type? Is it a case of thyroid insufficiency (Laignel- 
Lavastine!”?), which was at a standstill for years, and 
which broke down following the operation? Could it 
have been a mixed “Basedowianism” disorder, as de- 
scribed by Sainton?!* The Goetsch test was negative. 
The history of nervousness for years would point to- 
wards what has been termed a “‘vagotonic” disposition. 
