24 GENERAL PART 



the mid-brain by hypophysial and epiphysial tumors, and of brain tumors on 

 the hypophysis and epiphysis). 



A. Influence of the Ductless Glandular System on the Nervous System 



Very significant is the influence of the ductless glandular system on the 

 psychical and mental functions. This subject has been dealt with very often 

 in recent years, for instance, by Laignel-Lavastine, Bauer, Marburg, Munzer, 

 and others; and recently a considerable study has been published on the 

 subject by v. Frankl-Hochwart. 



I refer to the alteration in character that is almost always associated with 

 the development of Basedow's disease; to the psychical irritability, the incli- 

 nation to irascibility, the manic-euphoristic attitude of patients with Base- 

 dow's disease; to the apathy and the lack of interest of the myxedematous; 

 to the characteristic quiet mental attitude in hypophysial dystrophy, and the 

 feeling of mental want of strength in those suffering with Addison's disease; 

 to the depressive attitude of the tetany patient, and finally to the profound 

 influence that the ripening of the sexual glands at the time of puberty or 

 the loss of function of the sexual glands in castrates exercises on the psyche. 



The relations of the ductless glandular system to the vegetative nervous 

 system, as we shall see later, are not only important for the pathogenesis of 

 the ductless glandular diseases, but they possess also a great practical 

 interest through the fact that in many ductless glandular diseases they 

 simplify the solution of the individual symptom-complexes in many respects. 

 These relations are of two kinds: 



1. The ductless glands themselves are vegetative organs. They are sup- 

 plied by vegetative nerves and possess, therefore, central projection 

 fields. Thus the function of the ductless glands is in great measure 

 regulated by the nervous system. 



2. The ductless glandular system influences the excitability of the vege- 

 tative nervous system by the hormones that it gives off to the circula- 

 tion. At least this has been ascertained with certainty with regard 

 to adrenalin, and is in probability true of the other ductless glandular 

 hormones. I shall take up this point first. But before this I wish to 

 say something as to the anatomy and physiology of the vegetative 

 nervous system. 



As is known, the vegetative nervous system supplies chiefly the organs 

 with smooth muscle fibers. In its function it is partially independent, in 

 great degree, of the central nervous system. While the somatic or animal 

 nerves pass uninterruptedly from the central nervous system to their organs 

 of supply, the vegetative nerves are always interrupted in the vegetative 

 ganglia. We hence distinguish preganglionic and postganglionic vegetative 

 neurons. Langley divides the vegetative nervous system into two groups, 



