150 THE INTERNAL SECRETIONS 1920 



precursors of the nitrogenous wastes of the body and 

 there is good evidence to prove this physiologically and 

 clinically. 



At all events, this accumulation of cellular wastes 

 brings about the condition which Hertoghe has called 

 "thyroid infiltration" on well-known physical princi- 

 ples. We will presume that a given cell located in any 

 part of the body for the thyroid influence extends to 

 every corner of the human organism is not maintain- 

 ing its normal chemical activities, that it is suffering 

 with the condition which I have named "chemasthe- 

 nia." The cellular activities are lessened and, as a 

 result of this, the wastes of that cell are not prepared 

 for elimination and remain behind. As a result of this 

 there ensues an actual swelling of the cell due to the 

 effort on the part of the body to maintain a normal 

 osmotic tension. In other words, this increased osmotic 

 tension in the cell draws fluids from other parts of the 

 body, including the blood, lymph, and tissue juices, 

 which evens up this tension and, therefore, extends the 

 confines of the cell wall. We are in the habit of expect- 

 ing an infiltration of the skin in myxedema the very 

 name of this condition indicates that there is an edema 

 of the skin and this edema or process of swelling or 

 infiltration, as it is preferably called, is not limited by 

 any means to the superficial tissues of the body. 



It will be recalled that in Barker's paper, 2 from 

 which a quotation already has been made, he believes 

 that high blood pressure appears to depend chiefly on a 

 narrowing of the lumina of the arterioles in the pre- 

 capillary areas. What is the chief reason for the nar- 

 rowing of these lumina? May it not be that the 

 infiltrated cells which surround these prearteriolar 

 canals or vessels are pressing upon the channels 

 through which the blood usually flows, thereby reduc- 

 ing the circulation and also increasing the activity of 

 the heart muscle which is necessary to force the blood 



