22 THE INTERNAL SECRETIONS 1920 



tions of the posterior pituitary solution. Within a few 

 weeks his skin became soft and moist, with some sweat- 

 ing. His pains and aches left him; he said, "I feel 

 looser." He lost weight, and much of his accessory fat 

 deposits disappeared. Not only could he mentally call 

 forth an erection, but he often had spontaneous erec- 

 tions. Might not the sympathetic stimulation have 

 aroused some glandular activity, which is kept active 

 by the injections? Or are these changes in the skin 

 arid vessel-activity only related to the vegetative sys- 

 tem? 



A case of postoperative disorder, with the "settling" 

 of symptoms, was seen in a woman of 38 years, who 

 was always "nervous," with indigestion, headaches, 

 fatigue, and lack of ambition. Nothing seemed to give 

 her relief. In October, 1919, she had a partial hys- 

 terectomy for a fibroid without the removal of the ova- 

 ries. For three months she improved physically, and 

 then seemed to "slump," not with indigestion, head- 

 aches and "nervousness," but with a predominance of 

 vasomotor disturbances related to her gastrointestinal 

 tract. She developed angioneurotic edema of the mu- 

 cous membrane of the mouth and anal cutaneous junc- 

 tion. Her mouth became filled with "canker," small 

 patches of erosion of the membrane. Her tongue be- 

 came very red, cracked and swollen. Her color was 

 changed, and became of a "muddy" appearance, with 

 attacks of areal blushing. Her skin was dry, her hair 

 fell out, and her face and hands would "puff" or swell. 

 Are not these predominating symptoms vasomotor in 

 type? Is it a case of thyroid insufficiency (Laignel- 

 Lavastine 12 ), which was at a standstill for years, and 

 which broke down following the operation? Could it 

 have been a mixed "Basedowianism" disorder, as de- 

 scribed by Sainton? 13 The Goetsch test was negative. 

 The history of nervousness for years would point to- 

 wards what has been termed a "vagotonic" disposition. 



