228 THE PITUITARY, THYROID AND ADRENALS AS A SYSTEM. 



soiling the auriculo-ventricular arhythmia grows more pro- 

 nounced, and finally the cardiac contractions become entirely 

 irregular, until at last there is that condition which is some- 

 times spoken of as delirium cordis." But why this arhythmia 

 after the stage of insufficiency has begun? That the previously 

 overworked right ventricle had been the first to collapse in 

 diastole is evident. 



It seems to us that all these facts warrant the deduction 

 that the suprarenal secretion, mixed with the Uood-plasma, reaches 

 the right ventricle in its primary state, and serves mainly to in- 

 crease its propulsive power in order to insure adequate distribution 

 of the Nood in the lungs."** 



If the anterior pituitary body is the functional center 

 of the adrenals, exophthalmic goiter, due to overstimulation 

 of the former organ by an excess of thyroid secretion, should 

 show symptoms corresponding to those of digitalis, since we 

 have said that the adrenals were the mechanical source of these 

 symptoms. Again, as we have also stated that some of the 

 symptoms ascribed to the sympathetic system are of suprarenal 

 origin, both digitalis poisoning and exophthalmic goiter should 

 include in their symptomatology some signs usually attributed 

 to the sympathetic system. Any other drug might be selected 

 for the purpose, but digitalis alone approaches thyroid extract 

 in its power to stimulate the organs in question. 



Exophthalmic goiter being a chronic disease, while the 

 symptoms of digitalis poisoning given are those of an acute 

 condition (the erethic stage being only referred to, since the 

 cachectic stage does not typify activity of the organs), the 

 comparison is evidently in no way calculated to favor our argu- 

 ment. But even then, and leaving out only symptoms essen- 

 tially associated with chronicity, a common anatomical source 

 is easily traceable for many phenomena, notwithstanding the 

 dissimilar pathogenic agencies to which the two morbid states 

 owe their existence. In both, for example, excessive cerebral 

 hypera3mia and oxidation are manifested by violent headache, 

 excitability, insomnia, hallucinations, etc. The muscular 



71 Weakness of the right ventricle as a result oT suprarenal insufficiency is an 

 Important factor in the pathogenesis of pulmonary phthisis; its various phases 

 will be discussed when this disease is studied. S. 



