336 ENDOCRINE GLANDS 



failed to reveal any cardiac or pulmonary lesion. In 

 these cases, however, it was possible to find symptoms 

 which could only be interpreted by a lesion of the sympa- 

 thetic or the pneumogastric. These were : Disturbances 

 of the respiratory rhythm, a disturbance of the oculo 

 cardiac reflex (usually reversed), an irregularity of the 

 pulse with or without arrhythmia, pupillary disturbances 

 (inequality, instability, etc.); finally vaso-motor and 

 sudoral disturbances of the face and arms. Quite 

 frequently could be found at the same time disturbances 

 pointing to a hyperf unction of the thyroid; the gland 

 enlarged, the eyes protruded slightly; there was a slight 

 tremor of the hands and a certain amount of moisture of 

 the skin. 



This syndrome of Basedow's disease is explained by the 

 following physiological facts concerning the action of 

 the sympathetic on the thyroid. Fr. Franck and Hallion 

 have shown the definite vaso-motor action of the nerve on 

 the gland. Morat and Briare have determined that if the 

 stimulus is applied below the inferior cervical ganglion, 

 this is followed by a vaso-dilatation of the thyroid. This 

 is due to the irritation of the vaso-dilator fibres of the 

 thyroid coming from the cardio aortic plexus (Fr. Franck 

 and Hallion). 



To the symptoms of vagus-sympathetic stimulation are 

 added sometimes symptoms due to a lesion of the phrenic 

 nerve (special painful spots, dyspnea caused by effort, 

 immobilization of the diaphragm on the affected side). 



The X-ray in certain cases reveals a foreign body at the 

 level of the base of the heart in the zone of the cardiac 

 plexus. If the projectile has gone through the thorax, it 

 is possible to believe that it has injured the nerves on its 

 way and in this case the syndrome clears up as the nerve 

 fibres recover. 





