26 ENDOCRINE GLANDS 



certain cases of exophthalmos, or acromegalia, for instance 

 in which the histological characteristics undoubtedly 

 pointed to this. Certain facts resulting from cystic tu- 

 mors at the level of the pituitary show the damage which 

 can be made by a limited lesion, sufficient to disturb the 

 function of a gland and cause the appearance of dwarfism 

 as in the classical case of Souques and Stephen-Chauvet. 



But and this is important in ordinary clinical work- 

 the endocrine lesions are often simply inflammatory or 

 specific. The study of thyroiditis, or suprarenalitis, 

 associated with acute infections, such as, typhoid or 

 scarlet fever has been reported quite frequently during 

 the last few years. In the same way infectious diseases 

 have a well-known action on the pituitary. These diseases 

 cause, either cellular alterations, which result in acute or 

 subacute symptoms or interstitial alterations causing 

 chemical changes. It is mostly in tuberculous or syphil- 

 itic lesions of the endocrine glands that the symptoms ap- 

 pear most frequently and most characteristically. If 

 lesions of the thyroid, the adrenals, the parathyroids, 

 the pituitary do not respond to treatment and evolute 

 rapidly, those due to lues, however, can be very satisfac- 

 torily treated. The physician examining a patient with 

 symptoms of endocrine disturbance should keep in mind 

 the possibility of neoplasms, which cannot be cured and 

 inflammations, or irritations by compression as in the case 

 of bony lesions of the sella turcica. 



In taking the history it is well to remember the fre- 

 quency of infections as an etiological factor in lesions of 

 the endocrines. Here, as everywhere else, acquired or 

 congenital syphilis plays an important part. Hereditary 

 syphilis has often been found to be the cause of symptoms 

 of endocrine disturbance. The same applies to acquired 

 lues, be it in the case of myxedema, exophthalmic goitre, 



