THE SYMPATHETIC SYSTEM 33 



many cases have been reported suffering from melancho- 

 lia, desire to commit suicide and, particularly, torpidity 

 and mental confusion. Patients with Addison's disease 

 are sluggish; those with Dercum's disease melancholic. 

 Grouping together all these facts Laignel-Lavastine a few 

 years ago was able to bring together the psychic disturb- 

 ances and abnormality of the endocrines. These dis- 

 turbances are, however, not sufficiently systematized to 

 be as valuable indicators as changes in the skin, nutrition, 

 etc. All that can be said at present is that in view of our 

 ignorance of the cause of the development of certain in- 

 tellectual changes, the investigation of disturbances of 

 the endocrine may be of value. This is the case in the 

 mental changes during puberty and the menopause and 

 perhaps such an investigation may result in interesting 

 therapeutic conclusions. Nervous symptoms; such as, 

 epilepsy or tetany, are in certain cases indicative of endo- 

 crine disturbances. Generalized tetany, as seen in infants, 

 in pregnant women, and in adults, is probably an indica- 

 tion of parathyroid deficiency, whether there is a de- 

 ficiency of calcium or not. 



Another illustration of symptoms of endocrine origin can 

 be found in cardio vascular symptoms. We have known 

 for some time that hypotension and certain associated 

 manifestations, such as, the white line of Sergent, have 

 been considered as due to adrenal insufficiency. The 

 prognosis of certain acute affections (scarlet fever, ty- 

 phoid, etc.) has often seemed to depend on whether or not 

 the adrenals were affected, so much so, that a real adrenal 

 syndrome has been found in acute infections having as a 

 starting point cardio vascular changes. Inversely, arterial 

 hypertension seems in certain cases to be due to an in- 

 crease in the adrenal secretion. Dr. Harvier has studied 

 these various syndromes in this volume. We must, always 



