28 ENDOCRINE GLANDS 



and his co-workers, have shown the existence of a hyper- 

 secretion of suprarenalin as a result of emotions. Changes 

 in the adrenal secretion are liable to secondarily affect 

 the secretion of the thyroid; these experiments have also 

 shown a decrease in the secretion of suprarenalin by the 

 inhibition of the gland in certain severe emotions. These 

 facts, when related to clinical observations, allow us 

 to agree with Laignel-Lavastine that emotions are liable 

 to be the starting point of endocrine disturbances. What we 

 know of the sympathetic and the part that it plays in the 

 function of the vascular glands helps us further to under- 

 stand this possible action. But as in all other cases in which 

 emotions are blamed as a possible cause, the exact part 

 played by them remains complex and hypothetical. It is 

 often exaggerated and it is necessary in each case to deter- 

 mine exactly the importance of the emotional element. 



THE EXAMINATION of patients suffering from Endocrine 

 disturbances is taken up in the various chapters of this 

 volume. Sometimes our attention is drawn by the alter- 

 ation of the gland itself. The hypertrophy of the thyroid 

 in certain cases of goitre makes us look for alterations of 

 the gland. The absence of the testicle or their atrophy 

 after mumps makes us look for bony changes or other signs 

 associated with testicular insufficiency. The evidence of 

 a cerebral tumor, associated with bitemporal symptomat- 

 ic hemianopsia due to retro-chiasmic irritation, makes us 

 think of a lesion of the pituitary causing the various 

 symptoms associated with lesions of this gland. There 

 are, therefore, two types of symptoms: signs of a tumor, 

 or anatomical alterations of the endocrine glands, or of the 

 surrounding tissues, causing secondarily symptoms of 

 compression, or irritation and functional signs, showing the 

 aberration of the secretions with exaggeration or decrease 

 of the secretions. The first are usually easy to see, but 



