338 ENDOCRINE GLANDS 



(d) A Chronic Syndrome. This will go on for several 

 months and may be compatible with a state of perfect 

 health. "The regulating function exerted by the solar 

 plexus can be more or less compensated." (Laignel- 

 Lavastine) . 



II. CLINICAL STUDY. 



1. SUPERACUTE SYNDROME. The patient is taken with 

 a sudden excruciating epigastric pain in the deep perium- 

 billical region, sometimes even vertebral; this is accom- 

 panied either with a sensation of constriction or of 

 something going right through the body. The patient 

 screams and cannot move. 



Then he begins to vomit ; at first food, then fluids, then 

 bile, and this is followed by distensions of the abdomen 

 and bloody diarrhea. 



At the same time severe general symptoms appear, 

 coolness of the extremities, subnormal temperature, weak, 

 rapid pulse, fall in blood pressure, anuria and collapse. 



The patient dies very shortly. 



The clinical picture is that of a virulent peritonitis or 

 of an acute gall stone crisis. 



2. SUBACUTE SYNDROME. The onset is sudden, some- 

 times following an effort. The patient complains of a 

 severe pain in the region between the sternum and the 

 umbilicus, and simulates a spasm of the stomach, which 

 radiates to the back and both shoulders. This is followed 

 by vomiting, often fetid diarrhea. The pulse is weak, the 

 urines rare. The attack subsides after a time, but re- 

 peats itself. 



3. CHRONIC SYNDROME. 1. Neuritis of the Solar Plexus. 

 -This is characterized by abdominal pains. These start 



as a rule as isolated attacks, but soon become continuous 

 with paroxysms. These pains are spontaneous and have 



