THE SYMPATHETIC SYSTEM 41 



which the action of the endocrine glands was exerted on 

 other glands. Such is the case of infantilism which may 

 result from the effects of the thyroid, or the pituitary on 

 the genital organs. There are other cases in which several 

 endocrine glands are simultaneously affected, bringing on 

 pluri-glandular syndromes, the clinical explanation of 

 which varies : obesity of the menopause, Dercum's disease, 

 sclerodermia, certain types of senilism or of genito- 

 dystrophic gerodermia, are examples of these types of 

 cases. Whether we are dealing with such cases or others 

 apparently simpler, we must not forget the part played 

 by the sympathetic nervous system, which is very evi- 

 dent in certain diseases (Addison's), but more obscure 

 in others. 



Clinical investigation allows us to bring out certain 

 alterations of the endocrine glands, but what is often not 

 brought out is the nature of the functional glandular dis- 

 turbance, which causes the symptomatology: insuf- 

 ficiency, aberration, hyperfunction. I have already said 

 how difficult it was to decide and how very careful we must 

 be of our interpretations, always, however, remembering 

 the importance of aberrations by insufficiency which are 

 particularly efficaciously treated therapeutically. 



Finally, we must remember that in endocrine pathology, 

 outside of new growths a large place must be kept for 

 inflammation, and that rheumatism, tuberculosis and 

 syphilis are often the cause. 



The pathology of the thyroid, of the pituitary and of 

 the pancreas shows numerous examples of this. The possi- 

 bility of a luetic infection must be remembered and may be 

 very useful when the question of treatment comes up. 



Our therapeutics can be etiological and aim at treating 

 the disease which has caused the inflammation of the 

 endocrine glands. It can by radiology, or by surgical inter- 



