THE SYMPATHETIC SYSTEM 29 



may be absent when the second are present; these alone 

 are sufficient to often suggest therapeutic intervention. 

 The study of the thyroid shows numerous examples of this. 



The functional signs should always be looked for, 

 whether the signs of glandular anatomical disturbance are 

 present or not. They seem to have a predilection for cer- 

 tain systems. For instance, disturbances in growth, such 

 as, dwarfism, gigantism, etc., are usually due to distur- 

 bances of the sexual glands, the thyroid, the thymus, the 

 pituitary. What I have previously said of the morpho- 

 genic function of the endocrines, of their harmozones 

 which regulate development, shows the primordial im- 

 portance of disturbances of growth. It was believed, for 

 a long time, that the thyroid alone was responsible for 

 infantilism. We now know the part played by the pitui- 

 tary, the thymus and possibly the pancreas. The part 

 played by the pituitary and the thyroid on the genital 

 glands and growth is well known. All disturbances of 

 growth should suggest to the physician an investigation 

 of the function of the endocrines. 



Outside of disturbances of growth, alterations of the 

 bony tissues are often of endocrine origin. Acromegalia is 

 an example of this, so is rickets, osteomalacia, and many 

 other bony affections have been found to be of endocrine 

 origin. Recently, Professor Hutinel has shown how the 

 study of any dystrophy of the bones should suggest an 

 investigation of the endocrine system. Articular alter- 

 ations are sometimes related to a certain degree to endo- 

 crine lesions; chronic rheumatism is often associated with 

 thyroid insufficiency (Lancereaux, Paulesco, Souques and 

 Sergent) and clinical investigations in some cases reveal 

 the influence of the testicle, the ovary, the pituitary and 

 other glands. Here again, we should not limit ourselves 



