THE RELATIONS BETWEEN THE ENDOCRIN ORGANS 165 



thetic nerve cells are hyperirritable, sympathetic action predominates in 

 the individual ; if the parasympathetic nerve cells are hyperirritable, para- 

 sympathetic action predominates. Those patients belonging to the former 

 group are called "sympathicotonic," those to the latter, "vagotonic." The 

 term a vagotonia" is derived from the vagus, which is the most important 

 nerve of the parasympathetic group. 1 



Manifestations of Sympathetic Hyperirritability. Sympathetic hyper- 

 irritability (sympathicotonia) is manifested in some of the following 

 symptoms: Dilatation of the pupil; protrusion of the eyeball; lessened 

 lacrimal secretion; lessened salivary secretion; lessened mucous secre- 

 tion in the nose and throat; lessened secretion in the gastro-intestinal 

 tract, showing particularly as hypochloryhydria and retarded digestion; 

 lessened motility in the gastro-intestinal tract, showing a slowness in 

 emptying of the stomach ; contraction of sphincters of the gut, and a gen- 

 eral relaxation of the intestinal musculature leading to the common type/ 

 of constipation found in the acute infectious diseases ; rapid pulse and at 

 times rise of blood pressure, although vasoconstriction in one area is usual- 

 ly accompanied by compensatory vasodilatation in others ; increase in body 

 temperature due to (1) vasoconstriction in the superficial vessels which 

 interferes with the elimination of heat; and (2) an increased production 

 of heat resulting from the increased metabolic action; diminution in the 

 amount of urine; alimentary glycosuria; contraction of the ureter; con- 

 traction of the uterus ; goose flesh ; and increased sweating. Increased 

 suprarenal, thyroid, and pituitary secretion also follow sympathetic stimu- 

 lation; and this in turn produces symptoms varying in degree according 

 to the amount of extra secretion formed. 



Manifestations of Parasympathetic Hyperirritability. Parasympa- 

 thetic hyperirritability (vagotonia) is accompanied by some of the follow- 

 ing: Contraction of the pupil; widening of the eye slits; increased 

 lacrimation; increased secretion of the nasal, oral, and pharyngeal mu- 

 cous glands, conditions commonly known as catarrh; increased salivary 

 secretion; contraction of the laryngeal muscles, such as is met in laryn- 

 gospasm; increased bronchial secretion, such as is met in bronchitis; 

 spasm of the bronchial musculature, as found in asthma; hypermotility 

 and hypersecretion of the gastric glands, including that of hydrochloric 

 acid ; hypersecretion and hypermotility of the intestine, leading to colicky 

 pains and states of either spastic constipation and stasis or diarrhea, de- 

 pending much on the degree of stimulation and on whether the circular or 

 longitudinal muscles are predominantly the recipients of the increased 

 stimulation; irritable bladder; and incontinence of urine and feces. 



^he faulty terminology in which Eppinger and Hess's theory was originally 

 expressed and the dubious biology incorporated in its exposition have militated against 

 its general acceptance. While the fundamental conception seems to be a valuable one, 

 the lack of constancy in manifestations of "vagotonia" and "sympathicotonia" detracts 

 from clinical utility. Many more reliable data are needed. R. G. H. 



