CHAPTER XII 



VEGETATIVE DISTURBANCES, NOT DIRECTLY DEPENDENT ON 

 DISEASES OF THE DUCTLESS GLANDS 



The words "vegetative disturbance" [Vegetationstorung] to my knowl- 

 edge originated with Kundrat. By them we understand any inhibition of de- 

 velopment. Since the time it was known that the growth, and especially 

 the normal development of the organism was guaranteed only by a normal 

 development of the ductless glandular system, modern investigation has 

 been directed toward seeking the cause of the different vegetative disturb- 

 ances in the ductless glandular system. In the foregoing chapters an entire 

 series of vegetative disturbances were comprehended, which to-day we are 

 justified in regarding as referable to a functional disturbance of individual 

 ductless glands. It seems important for the following exposition, again 

 briefly to sketch what these are: 



1 . Absence of the thyroid leads to dwarfism ; in this is found characteristic 

 disturbances of ossification, consisting in a high-grade remaining behind in 

 development of the bone nuclei, and in the closure of the epiphyses, further 

 in a disturbance in development of the bone marrow; what, however, has 

 already been formed of the bones is of abnormal hardness; further there are 

 found disturbances in the dentition, and in development of the central 

 nervous system, whereby the development of the intelligence suffers. 

 Further there are found the characteristic myxedematous alterations of the 

 skin, and disturbances in the development of the genitalia. 



2. The vegetative disturbances in endemic cretinism is not dependent 

 alone on the goitrous degeneration of the thyroid gland. It is far more 

 likely that the deleterious agent acts also directly on the central nervous 

 system and on other ductless glands, for instance, the hypophysis. Thereby 

 the vegetative disturbances are extremely manifold, the individuals remain 

 very much behind in growth, but the disturbance in ossification is not 

 disproportionate; one time the developmental disturbances of the central 

 nervous system may stand in the foreground, another time the inhibition in 

 growth, and another time perhaps the disturbances in the development of 

 the hypophysis. 



3. Pronounced inhibition of development is found also in diseases of the 

 hypophysis that develop in early youth. In this case there occur, at least 

 in a suggestive manner, eunuchoid dimensions on account of a prominent 

 developmental inhibition of the sexual glands, and further there occurs 

 eunuchoid distribution of fat. Disturbances in the development of the bone 



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