THE SYMPATHETIC SYSTEM 327 



(c) Are signs of irritation of the sympathetic; 



1. The pigmentation of the skin in Addison's disease: 



2. The lumbar pains; 



3. The sudden death sometimes of reflex origin, the 

 abdominal pains, sometimes excruciating, the uncontrol- 

 lable vomiting, the diarrhea, the coolness of the extremi- 

 ties, the hypotension with tendency to collapse, which 

 characterize acute suprarenal insufficiency, resemble the 

 symptomatology which we will describe in the solar 

 syndrome, so much so, that the question comes up if the 

 signs of sympathetic inhibition are not a function of a 

 decreased secretion of suprarenalin, the normal stimulus 

 of this nerve. 



When all is said the syndrome of Addison's disease can 

 be considered as a manifestation of a disturbance of the 

 pigmentary suprarenal-sympathetic function. 



III. SCLERODERMIA can be considered as an endocrine- 

 sympathetic syndrome for the following reasons: The 

 theory which considers an endoperiarteritis of the blood 

 vessels as the starting point of the disease is incorrect. 

 We know to-day that vascular lesions are not the result of 

 lesions of the skin. 



Raymond claims a nervous origin for sclerodermia, 

 basing himself on the trophic, vaso-motor and secretory 

 disturbances, on the co-existence of a facial hemiatrophy 

 and on the symmetry of the lesions. Brissaud, struck by 

 the location of sclerodermia, considers this disease as due 

 to central medullary or spinal sympathetic root lesions. 



There is a tendency to-day to put the blame on disturb- 

 ances of the endocrine glands: thyroid, and suprarenal. 

 Sclerodermia may follow lesions of the thyroid of rheu- 

 matic origin and the treatment with internal secretions 

 has stopped its evolution. Its co-existence with Base- 

 dow's disease has been reported several times. In other 



