120 ENDOCRINE GLANDS 



In certain cases, hyperplasia of the thymus causes in 

 young infants a very definite clinical syndrome commonly 

 known under the name of enlargement of the thymus. 



I. HYPERTROPHY OF THE THYMUS. 

 SYMPTOMS. 



We will simply give the chief clinical findings. 



In its usual form, it is characterized by respiratory and 

 circulatory disturbances. The child has a loud and harsh 

 inspiration and expiration; inspiration is, however, the 

 louder of the two. This is associated with a marked 

 drawing in. Attacks of suffocation occur which may last 

 from a few seconds to quite a long period of time, and in 

 which asphyxia and even death may occur. During these 

 attacks, and also during the interval, the veins of the neck 

 are prominent and the face is cyanotic, showing a disturb- 

 ance in circulation. These attacks come on without any 

 apparent reason or after a fit of temper or tears. The 

 drawing in of inspiration, the cyanosis and the inspiratory 

 and expiratory rales are exaggerated in certain positions; 

 such as, in the hyperextension of the head for instance. 



In other types of cases, the respiratory disturbances are 

 not continuous. Periods of suffocation do occur, but in 

 between respiration is normal. 



Percussion of the manubrium and the radioscopic 

 examination of the mediastinum allow us to find the cause 

 of these respiratory difficulties in a hypertrophy of the 

 thymus and differentiate this condition from analogous 

 conditions of childhood. 



In these cases the therapeutic indications may be 

 Radiotherapy or partial removal of the thymus. 



ETIOLOGY. 



We do not know the causes of thymus hypertrophy. 

 Marf an considers it as one of the forms of proliferation of 



