154 THE INTERNAL SECRETIONS—1920 
We know there is nothing single in nature and con- 
sequently we can readily understand how a tubular 
structure, with double nerve supply, might fail to func- 
tion properly because of a lack of balance in its in- 
nervation. To me, the mechanism is just the same as 
the voluntary control of joints. Our anatomy has 
taught us that each voluntary joint has two antagonis- 
tic muscles or groups of muscles. Our physiology has 
taught us that each muscle is constantly in a state of 
tone produced by its nerve supply, and, further, that if 
the nerve supply of one group is lessened, the opposite 
or antagonistic group is overactive, or hypertonic. Can 
we not reason by analogy then, that if the sympathetic 
nerve-tone to a given tube or set of tubes is below par, 
the central nerve-tone will be above par, or vice versa? 
In other words, the nerve-tone of the tube is out of bal- 
ance and consequently there is dysfunction. Accord- 
ingly then, any dysfunction of the sympathetic nervous 
system is in reality a disturbed balance in the activity 
of the ductless glandular system, especially the adrenal 
system. 
The statement has often been made that some prac- 
titioners thrive because they have some few little things 
they lay stress on. Is it not true that all big things in 
life are mode up of little things? It is high time that 
the medical profession gave more attention to these 
little things. They may be met in your office almost 
every day and if you are not looking for them, they are 
missed. I know of no field in medicine that requires 
closer attention to little things than the study of these 
little glands. Here, close observation and minute atten- 
tion to detail is required. The majority of diagnostic 
sins are of omission rather than commission. This ap- 
plies, with especial emphasis, to the elucidation of 
minor functional disturbances of the ductless glandular 
system. Our treatment should be directed to the duct- 
less glands and the re-establishment of their normal 
