940 CHAELES E. DE M. SAJOUS 



1 



particularly difficult. They are discussed as fully as present knowledge 

 warrants in one of the chapters of this treatise. 



The general practitioner will find it helpful in studying the atypical 

 cases of endocrin disease to analyze the clinical picture piecemeal, putting 

 down one by one the single symptoms and signs that could be reasonably 

 attributed to overactivity or underactivity of each member of the chain 

 of endocrin glands in the body. There are so many overlappings of func- 

 tion and antagonisms of function in endocrin domains that a final judg- 

 ment in the assignation of single symptoms and signs to particular glands 

 is often exceedingly difficult. We should be content for the present with 

 objective descriptions of our findings, and, while we may legitimately 

 form hypotheses as to the meaning of these findings, it is desirable that 

 we should clearly differentiate between objective description on the one 

 hand and efforts at pathogenetic interpretation on the other. 



My own labors have tended to classify glandular syndromes obserA^ed 

 in diseases other than the endocrinopathies, but as the present work is 

 limited to the latter the reader must be referred to my work on the 

 internal secretions. 



4. The Significance of Balanced Activities of the En- 

 docrin Glands for Normal Structure and Function 



What has been learned of the changes in the body and in nervous and 

 mental states that occur in outspoken disorders of the functions of the 

 endocrin glands has brought medical men to the inevitable conviction 

 that a balanced activity of the internal secretory functions of the several 

 glands is essential for the production and maintenance of what we call 

 normal states. Even the differences in healthy persons in skeletal growth, 

 in facial characteristics, in the appearance of the integument, the nails, 

 the hair and the teeth, in nervous and mental states, and in metabolic 

 activities, may be, in no inconsiderable part, dependent, upon variations 

 within normal limits of the functions of the several endocrin glands. 



The general practitioner who has familiarized himself with the facts 

 of endocrinology will find it a fascinating study to try to interpret the 

 physical and mental make-up of his patients in the light of these facts. 

 He will be particularly helped in such considerations by a thorough knowl- 

 edge of the vegetative nervous system, including the sympathetic system 

 proper, and the craniosacral autonomic nervous system. These two re- 

 ciprocally antagonistic nervous systems are to a large extent played upon 

 by the hormones (or chemical messengers) from the several endocrin 

 glands. Functional pathology in the future will, in all probability, lay 

 even more stress than it does now upon the factors ascribable to the en- 

 docrin glandular system on the one hand and to the visceral nervous sys- 

 tem on the other. 



