26 THE INTERNAL SECRETIONS—1920 
ance in histological tissue, with a cessation or loss of 
function, the clinical picture is quite distinct. It will 
vary with the gland or number of glands involved and 
always be of the quantitative type. One may merely 
recall the cretin, the acromegalic, the Addisonian, etc., 
to recognize what we term a quantitative disorder. 
There are, however, a very much larger number of 
cases of what we might call a qualitative type. Might 
there not occur the same vascular activity either under 
or over the normal threshold, lessening or increasing 
the function without actual tissue loss? In the sys- 
tems mentioned previously, the nervous mechanisms ap- 
peared to be important, may be so in this system. This 
under- and overfunctioning, due to changes in the vas- 
cular tone, may also control the variation in the blood 
and tissue metabolism which is manifest in certain 
types of cases where adjustment takes place moderately 
quick. Eppinger and Hess'® have presented facts to 
show that the various organs produce sympathicotropic 
and vagotropic impulses, which either increase or de- 
crease metabolism. Perhaps this is most manifest in 
the case of the thyroid, as under experimental or thera- 
peutic feeding of thyroid, there is an increase in the 
metabolism of carbohydrates. Higier’® places the thy- 
roid in the catabolist group. 
Gley has stated: “ .. . it follows that the tone of 
the muscles of the blood vessels in so far as it depends 
on an automatic stimulation, either direct or indirect, 
is maintained not only by nervous stimulation, varia- 
tions in gases contained in the blood and by the prod- 
ucts of the catabolic processes, but also by a specific 
substance normally found in various glands. 
Many have occupied themselves with determining these 
functional correlations of a chemical nature, connecting 
them with one another and at the same time differen- 
tiating them from the correlation of the nervous origin 
—it was also recognized that there are still others 
