26 THE INTERNAL SECRETIONS 1920 



ance in histological tissue, with a cessation or loss of 

 function, the clinical picture is quite distinct. It will 

 vary with the gland or number of glands involved and 

 always be of the quantitative type. One may merely 

 recall the cretin, the acromegalic, the Addisonian, etc., 

 to recognize what we term a quantitative disorder. 



There are, however, a very much larger number of 

 cases of what we might call a qualitative type. Might 

 there not occur the same vascular activity either under 

 or over the normal threshold, lessening or increasing 

 the function without actual tissue loss? In the sys- 

 tems mentioned previously, the nervous mechanisms ap- 

 peared to be important, may be so in this system. This 

 under- and overfunctioning, due to changes in the vas- 

 cular tone, may also control the variation in the blood 

 and tissue metabolism which is manifest in certain 

 types of cases where adjustment takes place moderately 

 quick. Eppinger and Hess 18 have presented facts to 

 show that the various organs produce sympathicotropic 

 and vagotropic impulses, which either increase or de- 

 crease metabolism. Perhaps this is most manifest in 

 the case of the thyroid, as under experimental or thera- 

 peutic feeding of thyroid, there is an increase in the 

 metabolism of carbohydrates. Higier 19 places the thy- 

 roid in the catabolist group. 



Gley has stated : "... it follows that the tone of 

 the muscles of the blood vessels in so far as it depends 

 on an automatic stimulation, either direct or indirect, 

 is maintained not only by nervous stimulation, varia- 

 tions in gases contained in the blood and by the prod- 

 ucts of the catabolic processes, but also by a specific 

 substance normally found in various glands. . . . 

 Many have occupied themselves with determining these 

 functional correlations of a chemical nature, connecting 

 them v/ith one another and at the same time differen- 

 tiating them from the correlation of the nervous origin 

 it was also recognized that there are still others 



