44 8 



PLURIGLANDULAR DISEASES 



toms even where there is high insufficiency of the parathyroid glands. I 



know that much that is hypothetical is bound up with these attempts at 



explanation. In one point, however, I believe I can scarcely err, namely, in 



Jthe supposition that the rapidly progressing cachexia that is observed so 



I frequently finds its explanation not in the functional disturbance of one 



ductless gland, but in the progressive degeneration of the ductless glandular 



system. 



The etiology of multiple ductless glandular sclerosis of the ductless glands 

 seems to be of diverse nature. In many of the cases acute infectious diseases 



FIG. 77. Case with insufficiency of sev- 

 eral ductless glands (Observation LIV). 



FIG. 78. Slightly myxedematous facial expression. 



have preceded the beginning of the disease. Thus in the case of Josserand, 

 influenza; in the case of Gougerot and Gy a "hard to define acute" illness 

 occurred, as in my case also. The case of Sainton and Rathery was syphilitic. 

 In the case of Claude and Gougerot, and in that of Brissaud and Bauer there 

 existed at the same time tuberculosis. Histologically, in the cases in which 

 there were autopsies, there was found a simple sclerosis; except in the case 

 of Claude and Gougerot, where there was found in addition tubercle in the 

 thyroid gland. It is indeed very likely that the ductless glandular sclerosis 

 may depend very often on a tuberculous foundation, as Poncet and Leriche 



