Clinical Syndromes (Status 

 Thymicus, etc.) 



GEOKGE H. HOXIE 



KANSAS CITY 



Historical 



The thymus has been the subject of much controversy for nearly three 

 hundred years; "and in spite of the great amount of work devoted to it no 

 unity of opinion is as yet apparent. It was hoped that animal experimen- 

 tation would furnish the key to the puzzling clinical reports, but thus far 

 no series has been, accepted as final. 



The clinical interest in the subject centered first upon the observations 

 of thymic asthma and thymic death which had been accumulating from 

 the days of Plater (1614), until Paltauf's syndrome of status thymico- 

 lymphaticus widened the clinical field, and caused observers to study the 

 characteristics of that class of patients from which the victims of thymic 

 asthma and thymic deaths were drawn. 



Of late years, clinical interest in the thymus has been further increased 

 by the discovery (Weigert, 1901) that thymic tumors were present in a 

 large proportion of patients dying of myasthenia gravis. Even the 

 lymphorrhages have been called thymic lymphocytes. 



Still more interest has been aroused by finding that in 60 per cent to 

 95 per cent of the patients suffering from Graves' disease there was an 

 enlarged thymus; and that in such cases thyroidectomy without thymec- 

 tomy (or the equivalent radium or X-ray treatment) failed to relieve the 

 symptoms. 



Present Status of the Thymus Problem 



The status of affairs to-day is, then, that an increasing number of obser- 

 vations show that the thymus is involved in these disease syndromes. 

 Whether its relation to them is at all causal remains to be proven. 



The weight of evidence would seem to indicate that thymic hypertrophy 

 and hyperplasia are a response to constitutional conditions in which the 

 thyroid proves itself failing or inadequate. That is, it is a phenomenon 



395 



