46 GENERAL PART 



bodv. Martins says "die Gesamtkonstitution ist die Summe der Teilkon- 

 stitutionen" [the total constitution is the sum of the partial constitutions]. 

 I might suppose that from the study of the physiology and pathology of the 

 ductless glandular system we have obtained a deeper insight into one of 

 these partial constitutions. At all events we must not accept the ductless 

 glandular system for itself alone, but must regard as a constitutional com- 

 ponent the ductless glands as vegetative organs together with the nervous 

 system regulating their functions. Wunderlich distinguishes a strong, an 

 irritable, and a lax constitution. This classification seems also to apply to 

 those components of the general constitution whose differentiation we are 

 at present concerned with. We can group individuals into those with 

 stabile, those with debile and those with labile, vegetative nervous systems, 

 and individuals with stabile, debile, and labile ductless glandular systems. 

 The certain degree of autonomy that is an attribute in general of the duct- 

 less glandular system has as a sequel the fact that the corresponding partial 

 constitutions may occur separately; the intimate relations that exist between 

 both systems would lead us to expect, however, that they are to be very often 

 found united in the same individual or that where one is present the other is 

 at least suggested. As the hereditary factor is very prominent in both, we 

 find them in the most diverse variations and combinations in members of the 

 same family. In individuals with a predisposition to a debile vegetative 

 nervous system there develop, under the demands that life makes on the 

 organism, an asthenia of the vegetative organs with general enteroptosis, 

 sluggishness of evacuations, anomalies of the secretion of gastric juice, de- 

 pressive mental attitude, in short the features that are an expression of Stiller's 

 asthenia. In the individuals predisposed to a labile vegetative nervous 

 system, readily accessible to irritations, there exists a tendency to neuras- 

 thenia, hysteria, and the vasomotor-trophic neuroses. It seems to me that 

 this classification may be applied in the smallest detail to the ductless 

 glandular system. The ductless glandular debile individuals are those in 

 whom there is not only a small functional breadth, but perhaps also a certain 

 tendency for certain diseases, especially for infections, or a slighter resistance 

 against alcohol or against certain toxins that may proceed from a focus of 

 infection somewhere in the body. To me the most interesting are the duct- 

 less glandular labile individuals. These are individuals who several times in 

 the month show extraordinary variations in the body weight, or those in 

 whom the thyroid swelling that occurs normally during pregnancy leads to 

 slight manifestations of Basedow's disease, or those in whom a strong emo- 

 tional excitement calls forth temporary glycosuria, or perhaps those in 

 whom slight symptoms of acromegaly occur during pregnancy, or women in 

 whom exist marked dysmenorrheic distresses. In this group are always to 

 be found, too, some symptoms that point to an especial lability of the vegeta- 

 tive nervous system. I need not attempt the description of the stabile in- 



