332 ENDOCRINE GLANDS 



mediastinal pleurisy, syphilitic and tuberculous affections 

 of the mediastinum. We have observed the beginning of 

 a Claude Bernard Homer syndrome in a tuberculous 

 woman with an artificial pneumothorax. 



2. In cervical and mediastinal tumors. 



Diseases of the thyroid (goitres and malignant tumors) . 



Cervical adenopathy (lymphadenomata, lymphosar- 

 comata). 



Neoplastic tumors of the esophagus and the trachea. 



Aneurism of the transverse aorta. In this case, the 

 inequality of the pupils is more often symptomatic of 

 nervous syphilis and co-exists with Argyll Robertson 

 pupils, but it can occur alone. The syndrome of Claude 

 Bernard has been reported in several cases. 



3. In vertebral lesions (Pott's disease). 



4. In traumatic lesions (bullet wounds). 



(e) REFLEX ORIGIN. An oculo sympathetic reflex syn- 

 drome has been reported in utero ovarian affections and 

 inflammatory or painful affections of the liver and pancreas. 



III. DISSOCIATED OCULOSYMPATHETIC SYNDROME. 

 A. EXOPHTHALMIA. 



During the course of chronic nephritis with hypertension 

 a slight bilateral exophthalmos is noticed without any 

 other ocular or other signs of Basedow's disease. This is 

 due to an intoxication of the ocular sympathetic in which 

 suprarenalin or analogous substances probably play an 

 important part. 



We can also include among toxic exophthalmia certain 

 protrusions of the eyeball, observed during the course of 

 chloroform anesthesia, at the end of the stage of excitation 

 which seems to be due to irritation of the sympathetic and 

 coincides often with a swelling of the body of the thyroid. 



