32 THE INTERNAL SECRETIONS—1920 
dividuals are merely considered “‘nervous,” one is quite 
aware and the real basis of their trouble is passed by. 
A nervous disorder, however, should convey immedi- 
ately to one the idea of a state of restlessness, unhappi- 
ness, dissatisfaction, poor adaptation, which contains 
as its underlying condition a conflict in the inner 
psychic or psychobiologic harmony. 
The exact location of these higher brain centres is 
still a matter of dispute, and yet there is evidence that 
it has a close connection with the chromaffin system, 
which it may be recalled is really a collection of endo- 
crine structures. The most essential parts of the chro- 
maffin system are the nervous or posterior lobe of 
the hypophysis, the sympathetic ganglia and para- 
ganglia of Kahn, and the nervous elements in the adre- 
nals. This specialized nervous tissue has also been 
found embedded in the kidney, and even carried down 
with the ovaries and testicles in their development and 
descent. 
Functionally, this system produces in the granules of 
these cells the hormone adrenin. Exception has been 
taken to recognizing the adrenals as internal secretory 
organs because [Kahn] the chromaffin cells do not con- 
form to the type of epithelial cells nor their grouping 
to glandular structure, yet from a physiological view- 
point the internal secretory conclusion is quite justified. 
What can be the significance of this intimate association 
between the glandular and nervous elements? 
The production of adrenin in these cells is now an 
undisputed fact. It enters the blood stream via the vein 
directly. This product acts upon certain tissues and 
increases the activity of metabolism. 
A young girl of 15 years was frightened by the sud- 
den appearance of a burning mattress passing the win- 
dow, in which she was sitting. This fright, with later 
lack of sleep, produced a mental reaction not unlike that 
seen in schizophrenia. The systolic blood pressure was 
reduced to 90 mm., the pulse rapid and low tension. 
