S GENERAL PART 



citability of the sympathetic nerves (Loui's reaction, increased glycosuric 

 action of adrenalin). Therefore we conclude that there is an increased 

 function of the chromaffin tissue or at least there is an increased action of the 

 circulating adrenalin. Again, in Addison's disease, in which the function 

 of the chromaffin tissue is primarily diminished, we find a heightening of 

 the assimilation limits for carbohydrates. We explain this as due to with- 

 drawal of the inhibition exercised by the chromaffin tissue on the insular 

 apparatus and to a secondarily increased function of the latter. 



Newburgh, Nobel and 7 have contributed a further observation. Peroral 

 administration of thyroidin occasions in human diabetes a long-continued 

 hypertonia. We interpret this as the functional increase of the chromaffin 

 tissue in consequence of a heightened sensibility of this tissue or of its central 

 projection fields. 



Through this and similar experimental findings and clinical observations 

 the conclusion was drawn as to a reciprocal action between thyroid, insular 

 apparatus of the pancreas, and chromaffin tissue. This is .well shown in the 

 accompanying diagram (see Fig. i). 



As before stated, we are not as yet clear as to the intimate process of such 

 physiological correlations. This applies not only to the reinforcement 

 [Forderung] but also to inhibition. We have indeed assumed that increased 

 activity of the insular apparatus inhibits the function of the chromaffin 

 tissue or of the thyroid, and the converse. Another possibility consists in 

 the fact that adrenalin and the pancreas hormone act antagonistically to- 

 ward each other in the liver; the one in an acceleratory manner, the other 

 in a retarding manner, upon the diastatic processes; or the one acts for the 

 building up of glycogen, the other for its splitting up. Increased activity of the 

 one would therefore disturb the balance between the two ductless glands. 1 



As I have expressed in a recent communication, the relations between 

 thyroid and pancreas seem to me better based and explained in the following 

 way: Increased activity of the thyroid makes greater demand on the func- 

 tion of the insular apparatus. If the insular apparatus does not come up to 

 these demands, the balance between both becomes disturbed. This point 

 of view is supported by a series of clinical observations. 



It is futile to raise ideas as to physiological correlation which deal with 

 the question whether one ductless gland can act compensatorily for another. 

 Such an assumption depends upon entirely superficial observation. Every 

 ductless gland has its specific function, although similar features may enter 

 into the sum total of activity. As this point is of important significance, I 

 will quote some examples. The extirpation of the hypophysis, just as that 

 of the thyroid gland, brings about a condition in which the vegetative func- 

 tions are diminished (Aschner). Nevertheless, a dog deprived of its hypo- 

 physis looks otherwise than one deprived of its thyroid, as R. Paltauf lays 



1 Experiments of Zultizer and of Von Bdlint and Molnar point in this direction. 



