404 GEOEGE H. HOXIE 



chismus ; and a delicate velvety skin. The diagnosis is further confirmed if 

 we find hyperplasia of the lymph tissue of nose, throat and tongue and an 

 increase in the palpable cervical and axillary lymph-nodes. 



"For the identification of status lymphaticus among women, we rely 

 on the peculiar character of the skin of the body and extremities, the scanti- 

 ness of the axillary hair pad, the scantiness of the pubic and perineal hair, 

 hypoplasia of the genital apparatus, and particularly slender thorax and 

 extremities. Some women of decided status conformity have a marked 

 growth of hair on the face and upper lip." 



Symmers gives the prognosis thus, "The condition is sometimes ter- 

 minated by death, usually in children, but occasionally in young adults." 

 He thus links up the syndrome with mors thymica. 



He finds it a dangerous condition because (1) "it is attended by insta- 

 bility of the. lymphoid tissues, providing a mechanism which, when it is 

 once set in motion, is capable of so sensitizing the body as to produce ana- 

 phylactic phenomena varying in intensity from simple urticarial rashes to 

 convulsive seizures and sudden death. The same irritability of the lymph- 

 oid tissue is apparently responsible for lowering the threshold of infection, 

 particularly of those infections which gain entrance through the pharyn- 

 geal and faucial tonsils and the intestinal tract." 



(2) "It is a menace, because it is attended by defective development 

 of the muscular coat of the arteries, thus rendering them incapable of 

 withstanding changes in blood-pressure which in other circumstances are 

 lightly borne." 



In Bellevue Hospital 249 examples were found in the 4000 autopsies 

 previously mentioned. Of the subjects, 212 were males and 37 females. 

 Their ages were : 



Under 1 year 22 



1 to 10 years . 10 



11 to 20 years 20 



21 to 30 years 62 



31 to 40 years 57 



41 to 50 years 41 



51 to 60 years 19 



Over 60 years 11 



This should not be taken as standard for the occurrence of this syn- 

 drome among the populace at large because a public hospital in the con- 

 gested part of a large city is not so apt to have the same proportion of 

 babies from all classes, and of young females as would represent the nor- 

 mal run of our American population. On the other hand, the males 

 afflicted with status lymphaticus would tend to failure in early adult life 

 and thus reach just such a hospital in relatively large numbers. 



