318 ENDOCRINE GLANDS 



they undress in public red spots are liable to appear on the 

 chest (pudic erythema) and perspiration appears under 

 the arms. 



On examination large tonsils are found, a red pharynx 

 and in childhood adenoids. As adults they are subject to 

 sore throat; they often swallow and complain of consider- 

 able saliva in their mouth. The pharyngeal reflex is 

 abolished, but this anesthesia should not be considered as 

 a hysterical stigma. 



Their respiration is often interrupted by a sigh, followed 

 by a respiratory pause. These individuals often complain 

 of retrosternal discomfort. Examination of the heart 

 reveals a marked irritability. Extra systolic arythmia is 

 frequent, especially after a heavy meal. The pulse rate 

 is usually about 60 per minute. It is characteristically 

 unstable. At the slightest effort it beats more rapidly or 

 in some cases slows down. Respiration influences it 

 greatly. The blood pressure is below normal. 



These individuals often have gastro intestinal disturb- 

 ances. The appetite is good, but there is a sensation of 

 fullness after meals in spite of the fact that the appetite is 

 not satisfied. They have acid eructation and symptoms 

 of aerophagia. They have a tendency to constipation. 

 The reflexes are very rapid. . There is often a tremor of the 

 tongue, eyelids and fingers, and a marked dermographia 

 (sign of sympathetic hypertonia). The urines contain 

 large quantities of phosphates. The urinations are 

 frequent and of small quantity. Sexual excitability is 

 frequently exaggerated and shows itself by precocious 

 ejaculation and nocturnal pollution. 



2. VAGOTONIA. This is much more frequent than 

 sympathicotonia and is found mostly in young people. 

 The principal signs are: Narrow pupils, tendency to 

 bradycardia, or hypotension, respiratory arythmia, palpi- 



