CHAPTER XIII. 

 PLURIGLANDULAR SYNDROMES. 



The glands of internal secretion make up a system, each 

 one of them being more or less dependent on the other. 



They are connected with each other by synergy, antago- 

 nism or supplement each other, so that the lesion of one 

 gland causes modifications in others. 



There are definite proofs of this glandular relationship : 



1. EXPERIMENTAL. We know that there is a hyper- 

 trophy of the pituitary after castration and an atrophy of 

 the testicle after the removal of the thyroid. The thyroid 

 increases in size after the removal of the ovary. 



2. PHYSIOLOGICAL. The injection of corpus luteum 

 causes a marked vaso dilatation of the thyroid, and that 

 of the pituitary a vaso constriction (Hallion). 



3. ANATOMICAL. Autopsies on myxedematous pa- 

 tients, or patients with Basedow's disease show lesions of 

 several glands: atrophy of the genitalia, hypertrophy 

 of the pituitary, frequent hyperplasia of the thymus, an 

 increase in volume of the pituitary is the rule in Addison's 

 disease, as is testicular or ovarian atrophy in acromegalia. 

 In the syndromes attributed to one gland, autopsy always 

 shows pluriglandular changes. 



Myxedema, Basedow's disease, Acromegalia, do not, 

 however, belong to the group of pluriglandular syndrome. 



The term pluriglandular syndrome suggested by Claude 

 and Gougerot in 1907 must be understood in the clin- 

 ical sense. These writers have insisted that only the 

 clinical examination of the patient, by detecting various 



243 



