122 INTERNAL SECRETION 



MORS THYMIA AND THE STATUS THYMICO- 

 LYMPHATICUS. 



The laryngeal spasm of infants was termed asthma thymicum 

 by the older physicians, and its sudden fatal termination was 

 supposed to result from changes in the thymus. After very care- 

 ful investigation, Friedleben came to the conclusion that " neither 

 the normal nor the hypertrophied thymus is able to provoke laryn- 

 geal spasm, and that there is no such thing as asthma thymicum." 

 This view was, at first, very generally accepted. The fact, how- 

 ever, that in many cases of sudden death, post-mortem examina- 

 tion showed a distinct hyperplasia of the thymus, led Grawitz to 

 conclude (1888) that, in such cases, death was due to suffocation 

 from a mechanical compression of the trachea, and this explana- 

 tion is still, in many instances, held to be rational and sufficient. 



Another explanation was, however, offered by Arnold Paltauf 

 (1889). He insisted upon the existence of a specific constitutional 

 anomaly, suggested in Rokitansky's text-book (1861), and which 

 Paltauf describes as follows : 



"Pallor of the skin; well-developed panniculus adiposus; 

 hyperplasia of different parts of the lymphatic system, the 

 lymphatic glands of the neck, axilla, mesentery; enlargement of 

 the follicles of the naso-pharyngeal cavity, the intestinal walls, 

 the base of the tongue and the spleen ; the thymus larger than the 

 average. This finding points to a general pathological condition 

 of the body which is generally termed the lymphatic constitution. 

 The hyperplasia of the thymus and its abnormally prolonged 

 duration are not the causes of death, but are symptoms of the 

 general nutritional derangement, which is further evidenced by 

 the enlargement of the lymph-glands, tonsils, &c." 



Svehla next concluded, from the effects of thymus extract 

 upon the heart and the vessels, that the mors thymica of children 

 is due to hyperthymization ; that is, to the action of a substance 

 circulating in the blood, which is supplied in an increased quan- 

 tity by the hyperplastic thymus. 



The fact that the effects of thymus extract are not specific, 

 withdraws from Svehla's theory its most important support. And 

 yet Hart, writing quite recently, considers the theory of an accu- 

 mulation in the organism of the toxic products of metabolism as 

 the result of thymus hyperplasia, to be quite plausible. He 

 tions, there was paresis of the hinder extremities, " the cardiac 

 persistent thymus, rubbed down and prepared under sterile condi- 

 tions, there was paresis of the hinder extremities, " the cardiac 

 activity was much accelerated, the animals sat forward and stiffly 

 upright, as if in cardiac distress, in which attitude, after a few 

 moments, they died." Post-mortem examination showed that, 

 apart from hyperaemia, all the organs were healthy ; the supra- 

 renals showed signs of extreme hyperasmia with some haemor- 



