152 THE THYROID, THE THYMUS, AND THE ADRENALS. 



taneously confirms the enormous mass of clinical evidence 

 accumulated in recent years as to the value of thyroid extract 

 and accounts for the contradictory evidence recorded. The 

 features that have remained unrecognized, however, provided 

 the views advanced herein are sound, are: 



1. That the symptom-complex termed "cachexia strumipriva," 

 though of thyroidal origin, is a direct consequence of adrenal in- 

 sufficiency. 



2. That the thyroid gland is but an auxiliary organ to the 

 adrenals, in that it supplies the blood with a secretion which di- 

 rectly or indirectly increases the adrenal secretory functions and 

 thereby augments the activity of oxidation processes. 



EXOPHTHALMIC GOITER AND IMPAIRED FUNCTIONAL 

 ACTIVITY OF THE ADRENALS. 



The relationship between the adrenals and the thyroid 

 soon asserts itself when we transfer the analysis to the dis- 

 eases that are ascribed to excessive or insufficient thyroid 

 secretion: interpretations that are fairly exact, but which 

 nevertheless would now convey any meaning other than that 

 generally accorded them. Exophthalmic goiter at once sug- 

 gests itself in this connection. Instead, however, of attributing 

 the phenomena witnessed to the immediate action of an ex- 

 csssive amount of thyroid secretion upon the organism at 

 large, it now seems more exact to ascribe them to excessive 

 and continuous, direct or indirect, stimulation of the adrenals 

 produced by the corresponding excess of thyroid secretion. 



To demonstrate the existence of such a causal relation- 

 ship, however, the symptoms of this disease should be shown 

 to vary in a measure as they do when external poisons are 

 introduced into the blood. A relatively small excess of thyroid 

 secretion should also produce symptoms of suprarenal over- 

 activity, while a large excess should give rise to signs of in- 

 sufficiency. All these features are clearly sustained by the 

 semeiology of this affection: . 



Adrenal overactivity is exemplified by: 1. The cerebral 

 hyperoxidation, as manifested by headache, irritability, ex- 

 citability, capriciousness or unnatural gayety, hallucinations, 

 mania, and epileptic convulsions. 2. The unusual muscular 



