THE ESSENTIAL DUCTLESS GLANDS 233 
in old age the thyroid becomes atrophied, its follicles 
shrink and retrogressive changes take place in the 
epithelial cells. This is reénforced by the fact that there 
is a profound analogy between the signs of advanced 
old age and those of myxedema. The falling of the hair 
and the dropping out of the teeth, the dry and wrinkled 
skin, the lowered temperature of the body, the dimin- 
ished perspiration, the indolent digestion and conse- 
quent emaciation, the reduced metabolism and conse- 
quent primary deposit of fat, followed by emaciation, 
the atrophy of the sexual organs, the decrease of mental 
power, and the diminution of the activity of the entire 
nervous system—these are all symptoms that caracter- 
ize chronic myxedema.” 
Sajous (3) on the other hand, is inclined to think that 
old age has more to do with deficiency of the function 
of the adrenals. The truth, however, is that in old age 
all the ductless glands are undergoing atrophic changes, 
which may account for the symptoms of senility. 
THE PARATHYROIDS 
In close proximity to the thyroid gland lie four di- 
minutive organs, called parathyroids, which were de- 
scribed first by Sandstrom in 1880. Though anatomi- 
cally connected with the thyroid, their physiological 
functions are entirely of a different character. The 
removal of these small glands produces a typical syn- 
drome. The patient acquires a tendency to spasms and 
convulsions,—which gradually assume the form of 
tetany, epilepsy, or even tetanus. The breathing be- 
comes labored, and the body temperature lowered. 
Ptyalism and fetid breath are often present. The 
amount of urine is decreased and the urine becomes 
more toxic. Death usually follows in from three to five 
days. 
The importance of these small glands seems to be in 
reverse proportion to their size. Their presence is 
