CLINICAL SYNDROMES (STATUS THYMICUS, ETC.) 397 



secondary to conditions elsewhere, and like fever should lead the observer 

 to seek out the primary cause. Certain it is that the problem is worthy of 

 study, and that it will be solved only by continued interest and the accumu- 

 lation of exact observations. 



It would seem that secondary hyperplasias of the thymus are accom- 

 panied by noticeable myasthenia, even in the case of Graves' disease. And 

 in those cases one finds a predominance of the epithelial elements of the 

 gland. On the other hand, the swelling of the gland, due to lymphocytic 



Fig. 3. Thymus in a child four years old dead with mors thymica (Dr. Addison 

 Lea). 



invasion, seems connected with a toxic influence on the body, whether in 

 Sajous' sense of nuclein metabolism, or in Symmers' sense of anaphylaxis 

 remains unsettled. 



The accompanying figures (Nos. 1-5) illustrate the normal thymus at 

 birth and at three months, the hyperplastic thymus at four years, the 

 participation of the thymus in a septicemia at twenty-three, and the type 

 of thymus found at operation in a case of myasthenia. 



Clinical Aspects of the Thymus Problem 



In its clinical aspects the thymus problem presents a number of inter- 

 esting phases. These will first be taken up under the captions: Thymic 

 Asthma, Mors Thymica, Status Thymicolymphaticus, Timme's Multi- 



