THE ESSENTIAL DUCTLESS GLANDS 233 



in old age the thyroid becomes atrophied, its follicles 

 shrink and retrogressive changes take place in the 

 epithelial cells. This is reenforced by the fact that there 

 is a profound analogy between the signs of advanced 

 old age and those of myxedema. The falling of the hair 

 and the dropping out of the teeth, the dry and wrinkled 

 skin, the lowered temperature of the body, the dimin- 

 ished perspiration, the fndolent digestion and conse- 

 quent emaciation, the reduced metabolism and conse- 

 quent primary deposit of fat, followed by emaciation, 

 the atrophy of the sexual organs, the decrease of mental 

 power, and the diminution of the activity of the entire 

 nervous system these are all symptoms that caracter- 

 ize chronic myxedema." 



Sajous (3) on the other hand, is inclined to think that 

 old age has more to do with deficiency of the function 

 of the adrenals. The truth, however, is that in old age 

 all the ductless glands are undergoing atrophic changes, 

 which may account for the symptoms of senility. 



THE PARATHYROIDS 



In close proximity to the thyroid gland lie four di- 

 minutive organs, called parathyroids, which were de- 

 scribed first by Sandstrom in 1880. Though anatomi- 

 cally connected with the thyroid, their physiological 

 functions are entirely of a different character. The 

 removal of these small glands produces a typical syn- 

 drome. The patient acquires a tendency to spasms and 

 convulsions, which gradually assume the form of 

 tetany, epilepsy, or even tetanus. The breathing be- 

 comes labored, and the body temperature lowered. 

 Ptyalism and fetid breath are often present. The 

 amount of urine is decreased and the urine becomes 

 more toxic. Death usually follows in from three to five 

 days. 



The importance of these small glands seems to be in 

 reverse proportion to their size. Their presence is 



