414 GEOEGE II. HOXIE 



Thymus in Prostatitis 



In this connection I should like to call attention to 1;he consistently low 

 blood pressures accompanying this syndrome of inflamed prostate and sub- 

 manubrial dullness. In apparently robust men the blood pressure will 

 rarely exceed 100 mm. That it is not constitutional is shown by the fact 

 that as soon as the absorption from the prostate ceases, the blood pressure 

 rises to normal levels, and the substernal dullness disappears. 



Clinical Symptomatology of Thymic Hyperplasia 



In the infant the symptoms of thymic hyperplasia are those due to its 

 size. But in the adult we find another group of symptoms, mentioned 

 briefly in a previous paragraph, apparently accompaniments of thymic 

 hyperplasia but explicable as being due to the preponderance of the sympa- 

 thetic nervous system and the related chromaffin rests. The symptoms are 

 asthenia, dryness of skin and sluggishness of all vegetative functions. 

 Thus we find the patients complaining of the difficulty in obtaining ade- 

 quate breath. They sit and yawn even while attempting to express their 

 complaints. The long sighing breath, usually not oftener than one in six 

 or seven, is more frequent and distressing. Constipation, of the atonic 

 type, also draws attention to the sympatheticotonia. The inability of the 

 patients to administer their business efficiently, or to carry out effectively 

 their work or play, should lead one to suspect this type of disorder. 



The differentiation from neurasthenia should not be difficult, because 

 in the latter we find either psychic or vagotonic influences (and symptoms) 

 predominating. This differentiation was noted in our discussion of myas- 

 thenia. 



In other words, we may expect in the adult some symptoms due to the 

 weakness of the thyroid and its synergists, and other symptoms due to 

 the size and (possible) secretions of the thymus. Thus the lack of 

 energy may be due to the hypothyroidism, but the sensations of smoth- 

 ering and breathlessness are probably the result of thymic hyperplasia. 

 The blood picture should show a relative increase of the mononuclear ele- 

 ments. But this finding is common to many asthenic conditions and 

 hence is not pathognomonic. Xo uniform condition of acidosis has been 

 reported. The Goetsch test is usually positive in this condition because 

 of the sensitiveness of the sympathetic system. But the blood pressure is 

 uniformly low, the usual finding being diastolic 60-70 and the systolic 

 90-100. 



