18 ENDOCRINE GLANDS 



suprarenalin being in the blood in excessive quantity with- 

 out being destroyed and that a morbid syndrome would 

 result from it. Two examples in endocrine pathology \vill 

 do more to explain this than anything else. Exophthalmic 

 goitre was for a long time considered as a manifestation of 

 hyperthyroidism and opposed to myxedema. Facts have, 

 however, been published making the interpretation for 

 the first of hyperthyroidism and the second of myxedema 

 very difficult. Since exophthalmic goitre has been studied 

 more closely and that the lesions have been more care- 

 fully investigated it has been recognized by Roussy and 

 others, that therapeutic hyperthyroidism could not be 

 compared to true Basedow's disease and that the latter 

 was a manifestation of dyshypertrophy of the thyroid, 

 that is, an exaggerated and abnormal thyroid secretion. 

 This idea is certainly the clearest of our present know- 

 ledge on the subject. In the same way, acromegalia has 

 been considered by some to be a manifestation of hyper- 

 function. It is relatively frequent to see patients suf- 

 fering from adiposo genitalis of the adult, (which has been 

 blamed, not without reason, to an insufficiency of the 

 pituitary) show evidences of acromegalia. I have person- 

 ally seen two cases of this type. The possibility of a 

 dyshyperplasia of the pituitary is best adapted to the facts 

 and would explain the presence of some symptoms due to a 

 functional deficiency with those of hyperf unction. The 

 more we understand the syndromes associated with 

 alterations of the endocrine glands, the more we see the 

 complexity of their functional disturbances. Does this 

 fact not also hold in disturbances of the liver and the 

 kidney, which cannot all be brought back to an insuffi- 

 ciency or a hyperf unction? It is, nevertheless necessary, 

 be it only from a didactic point of view, to look at them 

 from the triple point of view of insufficiency, hyper- 



