CLINICAL SYNDEOMES (STATUS THYMICUS, ETC.) 413 



the stage when the epithelial organ is being' transformed into a lymphoid 

 organ. The cells with large clear nuclei are thymic epithelial cells. . . . 

 There is no true differentiation into cortex and medulla in any part of the 

 tumor examined; but some areas contain many more lymphocytes than 

 other portions. It is to be remembered that the entire reticulum of the thy- 

 mus is of epithelial origin, and that the cortex normally contains a great 

 many more lymphocytes than the medulla; the latter retaining somewhat 

 of an epithelial appearance in the fully formed gland. 



"No corpuscles of Hassall are to be seen. These structures do not 

 appear in the development of the thymus until the medulla has become 

 well defined, and since the tumor tissue has 'not yet attained that stage of 

 differentiation one would not expect to find them. However, there can be 

 no doubt that the tumor is composed of young thymic tissue, even though 

 no corpuscles are present. 7 ' 



Subacute and Arrested Cases. As the syndrome is becoming better 

 known, more cases are being recognized ; and there are appearing case re- 

 ports of all degrees of formes frustes as well as reports of apparent recov- 

 ery or at least of remission. Eosenbeck, for example, reports two such 

 cases. Thus there is ground for hope that the accumulation of greater 

 material will enable us to understand the disease better, and 'ascertain the 

 role of the thymus therein. 



Treatment. One cannot help feeling that the treatment of the thymus 

 in this disease is justified, and that the type of treatment should be that 

 of exposure to the radium or the X-ray, on the theory that thymic over- 

 activity is responsible for many of the symptoms. 



Thymus in Tetany 



Latterly, the laboratory workers have implicated the thymus in the 

 tetany which appears occasionally among experimental animals. Very 

 little on the point has appeared in the literature from the clinicians. In 

 my own experience, there is only one case that suggests the condition. 

 This was that of a physician wHo had a combination of prostatitis and 

 submanubrial dullness ascribed to thymic hyperplasia. His myasthenia 

 and "nervousness" had reached a point where it was necessary for him to 

 give up his practice. But the discovery of the real nature of his ailment, 

 and massage of the prostate led to immediate relief and the resumption 

 of his work. 



He had two tetanic seizures while under observation, the second one 

 due directly to the milking of the prostate and vesicles. It was accom- 

 panied by greatly increased temperature. It is interesting to note that the 

 chest condition cleared up parallel with the prostatitis, thus suggesting 

 that the submanubrial dullness was secondary to the pelvic trouble. 



