CLINICAL ASPECTS OF ENDOCRINOLOGY 19 



cutaneous blood vessels and the dermal system of invol- 

 untary muscles (Gaskell 6 ). Correspondingly, in the 

 gastrointestinal tract are the secretory glands, the ex- 

 tensive vascular supply and the unstriped or smooth 

 muscle extending from the middle third of the esopha- 

 gus to the internal sphincter of the rectum. Each part 

 of this mucocutaneous system is under neurogenic 

 control either through the sympathetic, the autonomic 

 or the cerebrospinal nerves, and these govern, undoubt- 

 edly, its biochemical and metabolic processes. Lang- 

 ley, 7 Schoff 8 and Sherrington, 9 have shown quite clearly 

 the neurogenic control of the sweat glands, the erection 

 of hairs, the phenomenon of "goose flesh," in the skin ; 

 and the hypersecretory activity of the intestinal glands, 

 as well as the peristaltic rhythm of the component parts 

 of the alimentary canal. 



ENDOCRINE MANIFESTATIONS IN THE SKIN 



If one should consider the approach towards the de- 

 velopment of a diseased or disordered endocrine gland, 

 is it not of primary importance to determine the activ- 

 ity of the sweat glands, the condition of the skin, the 

 growth of hair, and such facts concerning the mucous 

 membranes as can be seen? So characteristic are the 

 signs manifest in the skin and mucous membrane 

 accessories that the actual gland affected, either in its 

 hyper- or hypoactivity, will depend upon the hyperidro- 

 sis, the dryness or smoothness of the skin, the lack of 

 hair or its anatomical distribution, etc. 



How often one will hastily diagnose a case as hyper- 

 thyroid or hypopituitary upon the excessive sweating 

 in the former and the unusual hair distribution in the 

 latter, and yet, oftentimes neither will react to the pre- 

 sumably indicated therapeutic measures. It is because 

 of this tendency to enter the sphere of true quantita- 

 tive disorders immediately that urges the writer to de- 

 lay and emphasize these prequantitative types. For 



