232 MAN AN ADAPTIVE MECHANISM 



defense by muscular action. On the other hand, it 

 would seem that Graves' disease is a purposeless driv- 

 ing of the mechanism by some obscure stimulus con- 

 nected with a pathologic alteration in the function 

 of the thyroid which is, as we have stated, apparently 

 the pacemaker of the kinetic system. 



That these several activations involve the same 

 mechanism is evidenced further by many other points 

 of similarity between Graves' disease and infections. 

 The likeness of the phenomena of Graves' disease to 

 those of chronic infections, particularly of tuberculosis, 

 is so marked that it is not at all uncommon to find 

 diagnosticians of wide experience recommending treat- 

 ment for tuberculosis to a patient with Graves' disease 

 and an operation for Graves' disease to a patient with 

 tuberculosis. In two different cases of the same degree 

 of intensity, it is almost impossible to distinguish the 

 case of Graves' disease from the case of tuberculosis. 

 Sometimes, both conditions may be present in the 

 same patient. The following symptoms are common 

 to both Graves' disease and tuberculosis ; tachycardia, 

 increased respiration, flushed face, tremors, persistent 

 slight fever, nervousness, rapid loss of weight, digestive 

 disturbances, hyperplasia of the thyroid and of the 

 lymph glands and enlargement of the heart. Even 

 at autopsy the lesions barring the tuberculosis 

 focus itself may be so nearly identical in the two 

 cases as to baffle differentiation. In tuberculosis as in 

 Graves' disease, the entire kinetic system is over-driven. 



Thus, the kinetic theory of Graves' disease, of infec- 

 tion and of emotion supplies a possible biologic interpre- 

 tation of the induction of these states, of their mutual 



