124 ENDOCRINE GLANDS 



splendid health or following some shock or some trivial 

 incident; such as, a cold bath, etc. Whether in a child or 

 an adult, the phenomenon occurs very rapidly and the 

 syncope is very different from the mechanical asphyxia. 

 Furthermore, at autopsy, the hypertrophied thymus 

 does not seem to have compressed any of the surround- 

 ing organs. 



3. SUDDEN DEATH DURING ANESTHESIA. It occurs 

 under similar conditions. The patient, usually young in 

 years, is anesthetized for an operation. In the middle or at 

 the end of the operation, sometimes even a few hours after- 

 wards, occurs a cardiac syncope without any warning. 

 The face becomes pale, the pupils dilate, the heart stops, 

 while the lungs keep on functioning. All means employed 

 to revive the patient, such as, artificial respiration, direct 

 massage of the heart, etc., are of no avail. The condition 

 is always fatal. It is independent of the choice of anes- 

 thetic, for it is observed just as well with ether, as with 

 chloroform, or ethyl chloride. It is also independent of 

 the doses used as it sometimes occurs after the administra- 

 tion of only a few drops, the patients sometimes having 

 been anesthetized previously without any untoward effects. 



On autopsy, the thymus is found usually enlarged 

 weighing 30 to 40 grams, hypertrophied or at least in 

 which involution has not occurred. 1 (1) Sometimes also 

 the spleen is swollen, the superficial and deep glands are 

 increased in size as well as Peyers patches and the closed 

 follicles of the intestines. 



1 Lucien and Parisot have very rightly drawn attention to the fact that a certain 

 number of observations of sudden death due to hypertrophy of the thymus gave a 

 weight for the gland which varied from 10 to 22 grams in children and 20 to 50 grams in 

 young adults. In these cases the hypertrophy is not real and may not be the cause of 

 the death. In order to be able to testify that there is a hypertrophy of the thymus, it 

 is necessary that the weight of the organ be notably higher than that for the average 

 for the age of the individual. This is important from a medico-legal point of view. 



