274 THE INTERNAL SECRETIONS—1920 
marked the exhibition by both of vasomotor excita- 
bility, dermographism, urticaria and transient edemas. 
Anaphylaxis is known to be produced by the entrance 
into the general circulation of protein matter foreign 
to the human body.’ It is not definitely known to be 
due to anything else, yet similar symptoms actually 
occur in hyperthyroidism. 
That excess amounts of thyroid secretion in the 
general circulation may be one immediate cause of 
certain urticarias and transient edemas (i. e., anaphy- 
lactic-like symptoms) would therefore, on first thought, 
appear to be plain. Yet it must be recalled that the 
phenomena under consideration are definitely localized 
vasoconstrictions; and that the function of vasocon- 
striction belongs not to the thyroid gland or its secre- 
tion, but to the involuntary nervous system and the 
thyroid antagonists, i. e., the posterior lobe of the 
hypophysis and the adrenal medullary tissue or chro- 
maffin system. Thyroid secretion per se, if in excess, 
actually produces vasodilation, and not vasoconstric- 
tion. On second thought, therefore, we are convinced 
that the thyroid cannot alone cause urticarias and 
transient edemas, but that its antagonists may do so 
under certain conditions. 
It is, therefore, plain that a classification of the va- 
rious forms of urticaria simply as vasomotor neuroses 
does not go quite far enough. A disease whose prin- 
cipal symptom is a localized vasoconstriction cannot 
be regarded solely as a disorder of the nervous sys- 
tem, when at least two different ductless glands are 
known to produce internal secretions which possess 
a marked capacity to bring about vasoconstriction. 
Definite doubts consequently arise as to whether either 
of the nervous systems plays more than its usual role 
—that of conductor of impulses only—in disorders of 
this type. Furthermore, it is difficult to conceive how 
anaphylaxis, recognized as the result of a foreign pro- 
