THE DUCTLESS GLANDS AND CONSTITUTION 45 



megaly be regarded as a pluriglandular disease; this is not new, however, but 

 was already mentioned by Pineles in his classical work. In addition to 

 hyperplasia of the hypophysis, we not rarely find, in acromegaly, symptoms 

 of Basedow's disease, in the later stages eventually symptoms similar to 

 myxedema, also to diabetes, and in the most cases, as is known, premature 

 disturbances on the part of the glands of generation, which may, however, 

 be sometimes preceded by temporary increase of their function. Of late 

 years, too, have been issued reports as to hyperplasia of the suprarenal 

 cortex ; briefly, in acromegaly there conies about a pluriglandular hyper- 

 plasia of the ductless glandular system, which mostly is rapidly followed by 

 a degeneration and exhaustion. This, however, likewise belongs to the dis- 

 ease picture of acromegaly, and on this account we would hardly be likely 

 to confuse a Basedow's disease with an acromegaly. 



These pluriglandular disturbances are found much more pronouncedly 

 in many cases of gigantism. Here the hyperplasia would seem to be a par- 

 tial manifestation of an abnormal predisposition to growth of the entire body. 



Concerning the therapeutic results of opotherapie mixte, that have been 

 hailed with such enthusiasm, they must be regarded with much scepsis, espe- 

 cially in so far as they are concerned with the trophoneuroses of the vege- 

 tative nervous system. However, I do not wish to deny the justification 

 for this therapy in combined diseases due to absence [Ausfall]. 



Desirable seems to me a sharper delimitation of the ductless glandular 

 diseases, not only from the vegetative neuroses, but also from certain vege- 

 tative disturbances. The regarding of chondrodystrophy as a ductless 

 glandular disease has been practically done away with. Mongolism is re- 

 garded to-day as a product of degeneration, in which a thyogenic component 

 is associated, at most. Lately, true dwarfism has been regarded as a disease 

 due to deficiency of the hypophysis, a view that will hardly meet with general 

 acceptance. Most obstinate are the attempts to obtain a place among the 

 ductless glandular diseases for true infantilism. In true infantilism the 

 organism, on account of a damage in fetal or postfetal life, does not progress 

 beyond the child stage of development. In this remaining behind, the 

 ductless glandular system participates, as well as the central nervous system 

 and every other organ of the body. There are, however, no indications that 

 the ductless glands functionate deficiently, which dictum holds also for the 

 sexual glands these functionate, but only as in the child organism; if they 

 were not to functionate, the genitalia and dimensions of the body would be 

 eunuchoid, but not infantile. 



The Ductless Glands and Constitution 



After the above attempts to delimit the ductless glandular diseases from 

 the disease groups that are related to them, I would add a few remarks as to 

 the significance of the ductless glandular system for the total constitution of the 



