2 GENERAL PART 



the new disease group in rapid succession. The discovery of pancreatic 

 diabetes by von Mering and Minkowski placed the pancreas as the central 

 figure in the pathogenesis of diabetes mellitus. Then later came the studies 

 of Schulze and Ssobolew as to the physiological and pathological independence 

 of the insular apparatus, and of Opie, Saltykoiv, W eichselbaum and others as 

 to the histological alterations in the insular apparatus in diabetes mellitus. 

 The very much later discovery by Blum of the glycosuric action of the 

 suprarenal extract and the knowledge that "sugar puncture" produces 

 discharge [of the secretion] of the suprarenal through conduction to the 

 chromaffin tissue by way of the sympathetic paths have again brought about 

 partial recognition of neurogenic origin of diabetes as first advocated by 

 Claude Bernard. For clinical purposes the chromaffin tissues won recog- 

 nition through the teaching of Wiesel, that hyper tonia in contracted kidney 

 originates through hyperplasia of the chromaffin tissue, and through the 

 recognition that in status lymphaticus the chromaffin tissue is ordinarily 

 found to be hypoplastic (Wiesel, Hedinger). "Thyroid tetany" was dis- 

 covered experimentally by Schiff and clinically by N. Wein. The discovery 

 of parathyroprivic tetany by Gley, Vassale, andGenerali dissociated, however, 

 the symptoms of tetany from those of absence of the thyroid gland and 

 ascribed to the parathyroid gland the decisive role in pathogenesis of the 

 individual forms of tetany (Jeandel-ize, Pineles, Erdheim, Chvoslek). After 

 Pierre Marie had already brought the disease acromegaly, which had been 

 described by him, into relation with the hypophysis, the fact became gen- 

 erally recognized that not, as was originally thought, a diminution but an 

 increase in function of the hypophysis brought about this disease; while in 

 1901 A. Frb'hlich and after him especially v. Frankl-Hochwart distinguished a 

 disease type, in many respects the anti-type of acromegaly, that through 

 the newer investigations of experimental pathology can be regarded as the 

 sequel of a diminution of function of this organ. The pathological anatomy 

 of the hypophysis was especially advanced by Benda, who established the 

 adenomatous character of the hyperplasia of the hypophysis in acromegaly, 

 and by the studies of Erdheim on squamous epithelioma in hypophysial 

 dystrophy. The histology of the struma of Basedow's disease was thor- 

 oughly studied earlier. The pathogenetic place of the thyroid then won 

 further significance through the operative treatment of Basedow's disease 

 (Rehn, Kocher, and others), and through the study of its relationship to 

 sporadic cretinism (" thyreoaplasie " of Pineles), to endemic cretinism 

 (V. Wagner, H. & E. Bircher, Ewald, Scholz) and to goiter heart (Fr. Kraus). 

 Also the significance of the sexual glands for many disease pictures was 

 more exactly studied. Eunuchoidism was sharply delineated by Tandler 

 and Grosz, and the clinical symptomatology of pmareture development of 

 the sexual glands was more widely developed. Then were added new 

 investigations as to the relation of the epiphysis [pineal gland] (Marburg, 



