CLINICAL ASPECTS OF ENDOCRINOLOGY 23 
The operation broke down this ‘‘conditioned” system 
and signs of vegetative disharmony came forth with 
vasomotor inactivity in the foreground. An adjust- 
ment of her vessel-tone caused the immediate disap- 
pearance of the edema, “‘cankers,” and swollen tongue. 
It is not possible that in the past such a disturbance 
would have been looked upon as a “reflex neurosis” — 
McGillicuddy,'t Hilton**—and that little attention was 
paid to the developmental personality and vagotonic 
disposition ? 
THE CARDIOVASCULAR MECHANISM 
The second system to be considered is the cardio- 
vascular system, which is composed of the heart, a 
special type of smooth muscle tissue, and the enormous 
extent of blood vessels from the larger arteries to the 
small capillary tubes and lymph channels. The blood- 
vessels contain in their inner coat the smooth striated 
muscle tissue with its vasomotor nerve control. In the 
majority of quantitative glandular disorders there is a 
disturbance in the cardiovascular mechanism, either an 
arrhythmia, a hyper- or hypotension, brady- or tachy- 
cardia. These symptoms occur of themselves, as was 
noted in the physical examinations of the recruits for 
the army, and many were accepted as soldiers, who 
later developed actual neuroses, under the strain and 
stress of army life. Oftentimes this stress upon the 
“conditioned”’ cardiovascular system brought forth 
symptoms highly suggestive of a thyroid or an adrenal 
membrane, the vasomotor disorders in their peripheral 
blood-vessels appeared to be most important. In the 
cardiovascular system, per se, there are such symptoms 
as swooning, fainting, epileptoid seizures, convulsions, 
—pseudo-myocarditis, pseudo-angina pectoris. Laig- 
nel-Lavastine has said that endocrine syndromes may 
depend not only upon a lesion of a corresponding gland 
or its regulating nervous mechanism, but indeed upon 
