THE SYMPATHETIC SYSTEM 21 



eral endocrine glands : adrenal and thyroids, thyroid, pit- 

 uitary and testicle, etc. A classification based on such 

 changes is, however, difficult to follow. 



There are certain conditions, such as, infantilism which 

 I have just referred to, in which the lesion of one gland, 

 the pituitary, for instance, seemed clearly to have pre- 

 ceded that of the other glands. In some cases where the 

 endocrine lesions occur simultaneously, the clinical symp- 

 toms are so characteristic that there is no advantage to 

 give it any other name. In other words, the knowledge of 

 a pluriglandular involvement helps us to interpret certain 

 clinical syndromes, and to determine what symptoms be- 

 long to such or such a gland and, while keeping to the 

 classical classification, treat these cases by means of mixed 

 organo therapy so as to overcome these various syndromes. 

 This idea helps us to better interpret and treat more 

 efficaciously certain diseases, the nature of which is still 

 rather indefinite. Take for instance, the obesity of the 

 menopause, instead of being entirely dependent on the 

 suppression of the ovarian function, it seems to be due to 

 simultaneous alterations of the thyroid and the pituitary. 

 Dercum's disease is believed to be of thyroid and pituitary 

 origin and the characteristic asthenia associated with this 

 condition is believed to be due to the adrenals. Sclero- 

 dermia is not due, as was believed for a time, to thyroid 

 lesions. The adrenals, the pituitary and perhaps the 

 ovary, seem to play a part in some of the symptoms of 

 this disease and mixed organo therapy can do a great deal 

 to relieve the condition. Diabetes often results from the 

 simultaneous alteration of several glands outside of the 

 liver and pancreas. While it is difficult to describe as 

 yet the definite symptoms the pluriglandular syndromes, 

 it is possible in certain well-defined diseases: obesity, 

 diabetes, sclerodermia, genital dystrophy, etc., to bring 



