I2O DISCUSSION 



rather than to the mental disease. Kojima 7 reported after a 

 very detailed study of oVer one hundred cases that the thyroid 

 weighed less among the insane. Of course, our classification 

 according to endocrine dysfunction was not made from observa- 

 tions on the morbid anatomy of the glands. 



Rossi 8 found in nine cases of manic depressive insanity 

 following influenza that there was marked adrenal insufficiency. 

 In six other manic depressive cases uncomplicated with influenza 

 there was similar adrenal insufficiency. The use of adrenalin had 

 good results. Prior 9 reported that among epileptics there was 

 very frequently degeneration in the adrenal cortex. Phillips 10 

 connected sporadic goiter with hyperthyroidism, excitement, agi- 

 tation, and manic depressive insanity, and connected endemic 

 goiter with hypothyroidism, apathy, indifference and dementia 

 precox. 



Laignel-Lavastine 11 draws correlations between abnormal 

 mental states and endocrine disorders. With mania he connects 

 disturbances of thyroid, adrenals, and ovaries. This quite tallies 

 with our results, for our cases with manic features were hyper- 

 thyroid and hypoadrenal. As our patients were all male, the 

 ovaries did not figure. With dementia precox he connects tes- 

 ticles, ovaries, and pituitary. Our experience is totally different, 

 for our precox cases showed disorders of thyroid and adrenals. 

 With epilepsy he associates thyroid, parathyroids, testicles and 

 ovaries, while our one epileptic, Vincent, showed dyspituitarism. 

 He cites genital perversions, not stating whether they are fan- 



7 Kojima, M., The Ductless Glands in no Cases of Insanity with 

 Special Reference to Hypothyroidism. Studies on Endocrine Organs of 

 Dementia Precox, Archives of Neurology (London), vol. 7 (1918). 



8 Rossi, S. C, Influenza, Suprarenal Insufficiency and Manic Depres- 

 sive Psychoses, Anales de la Facultad de Medicina (Montevideo), vol. 

 4, number 12, p. 801 (Dec., 1919). 



9 Prior, G. P. U., Mental Cases of Endocrine Considerations, Journal 

 of Mental Science (London), vol. 66, number 272 (Jan., 1920). 



10 Phillips, N. R., Goiter and the Psychoses, Journal of Mental 

 Science (London), vol. 65, p. 235 (Oct., 1919). 



11 Laignel-Lavastine, M., The Internal Secretions and the Nervous 

 System, Nervous and Mental Disease Monograph Series No. 30, 1919, 

 P. 32. 



