14 2 JOHN T. HALSEY 



using local Anesthesia that the prolonged vasoconstriction caused by the 

 epinephrin, which is added to the anesthetic solutions, favors the develop- 

 ment of local infection, and of necrosis (rarely). Consequently, there is a 

 tendency to-day to lessen the concentration of the epinephrin solutions 

 used. The arteriosclerosis produced experimentally justifies a fear that 

 similar changes may occur in man. However, while this possibility cannot 

 be denied, the weight of the evidence at present is against it. 



The Thymus 



While in the case of many of the endocrin glands employed thera- 

 peutically we have a fairly extensive knowledge of their physiological 

 function,' of their rule in pathology and of their effects when administered, 

 we have no such knowledge of the thymus.. It is true that extirpation 

 experiments of earlier investigators, such as Basch (c), Klose, Vogt, Matti 

 (a) (/;), Paton (a] (b) and others, indicated that this gland exerted an im- 

 portant influence on growth, especially of the bones, and that there was an 

 important relationship between the thymus and the thyroid, the testicles, 

 and perhaps still other endocrin organs. Later investigations, however, 

 such as those of Pappenheimer (a.) (&), Park, Nordmann (a), Morgulis, 

 Gies, Uhlenhuth and others have failed to corroborate these conclusions. 

 We must therefore admit that, as recently pointed out by Hos- 

 kins (/;) and Uhlenhuth (/), there are no facts known which warrant the 

 claim that the thymus does or does not produce any internal secretion 

 which is required to maintain the normal physiological condition of the 

 organ. 47 When orally administered, thymus preparations exert no imme- 

 diate pharmacodynamic actions, and, although the intravenous injection of 

 extracts of the gland causes a striking fall in the blood-pressure, there is 

 nothing specific in this action as it is similar to that exerted by extracts of 

 various other organs. (Basch considers it due to coagulation phenomena.) 

 The organotherapeutic employment of this gland must therefore, for the 

 time being, rest not at all on any rational or theoretical foundation but 

 entirely on an empiric one. 



Tlmnus medication has been employed with reported benefit in a 

 largo number of diseases of various types. The literature shows that it 

 has been considered useful or curative in goiter (both simple and toxic), 

 myxedema and cretinism, infantilism, marasmus, acromegaly, Addison's 

 disease, rickets, chlorosis, chorea, epilepsy, dementia prsecox, gout, chronic 

 arthritis, arteriosclerosis, carcinoma, tuberculosis, and hemorrhoids (!), 

 and doubtless a more thorough search would enlarge this list. An analysis 

 of the reported results of thymus therapy in the above mentioned diseases 



t hlenhuth believes, however, that the thymus does produce an internal secretion, 

 but one which, as far as we know at present, exerts only a toxic effect and which he 

 believes is probably the substance which causes tetany. 



