DUCTLESS GLANDS AND NERVOUS SYSTEM 2Q 



production of the secretion of the thyroid gland. Reversely, in typical 

 myxedema the vegetative functions are found to be delayed, slow; the excita- 

 bility of the organs supplied by the sympathetic and autonomous nerves is 

 reduced (slower pulse, sluggishness of the intestine, etc., or reduction of the 

 glycosuric action of adrenalin, absent or deficient hyperglobulia after the in- 

 jection of adrenalin, reduced action of pilocarpine, etc.). 



Then again the parathyroid bodies influence the excitement or excitability 

 of the vegetative nerves. In the acute stage of tetany are found hyper- 

 globulia, spasmodic conditions of the stomach and intestines, the bladder, 

 ciliary muscles, the heart, etc. The different actions of sympathicotropic or 

 automonotropic agents, such as adrenalin and pilocarpine, are essentially 

 strengthened. The circumstance that in tetany the manifestations on the 

 part of the vegetative organs are essentially different from those of Basedow's 

 disease shows that the affinities for the vegetative organs displayed by the 

 hormone of the parathyroids and the hormone of the thyroid are electively 

 different; and also the point of attack in the neuron is different, as in the one 

 case the hyperirritability [or hyperexcitability, Uberregbarkeit], the other 

 the hyperexcitement [Uberregung], is more prominent. 



In Addison's disease, as is to be expected, there is a reduction of the 

 excitability and a slighter tonus of the organs innervated by the sympathetic, 

 and especially prominent are the reduction of the blood-pressure and the 

 lessened action of adrenalin. Here the picture is complicated by a number of 

 symptoms depending on a strong excitement of the vegetative organs, symp- 

 toms the genesis of which is as yet doubtful. 



In the rest of the ductless glandular affections these relations are still less 

 apparent. I shall report the appropriate investigations and observations in 

 the respective chapters, and here shall only indicate the following: In hypo- 

 physial dystrophy and in eunuchoidism the excitability of some of the vege- 

 tative nerves seems to be somewhat decreased. Probably there exists a 

 certain sluggishness of the vegetative functions, which however does not 

 attain the degree of sluggishness of those in myxedema. Diabetes insipidus, 

 which not rarely is associated continuously or temporarily with diseases of the 

 hypophysis, seems to depend on an irritation of the posterior lobe of the hypo- 

 physis or on a specific increase of the function of the kidneys. In acromegaly 

 are found, not rarely, profuse sweats, even when no other manifestations 

 of complicating hyperthyroidism are present. In some cases of diabetes 

 mellitus, Lowi has shown an increased excitability of the dilator pupillae, 

 which is innervated by the sympathetic; we found in a definite category of 

 cases which perhaps are similar to Lowi's cases a strikingly strong glycosuric 

 action of adrenalin; in such cases, in which also the neurogenous factor of the 

 glycosuria markedly predominates, there is sometimes found an increase of 

 blood-pressure (hypertonic diabetes). 



Also the glands of generation seem to exercise an important influence on 



