78 The Philippine Journal of Science ' 1913 



constant presence of an enlarged thymus gland, coupled with 

 the clinical evidence of respiratory embarrassment in many cases, 

 has led many authors to claim that direct mechanical pressure of 

 the thymus is accountable for the sudden death. Thus has 

 arisen the much discussed question of the so-called "mors thy- 

 mica." The mechanical pressure of the thymus has been claimed 

 by some to be exerted on the trachea, by some on the heart, by 

 others on the vessels, and by still others on the nerves. Pressure 

 on the trachea, however, has attracted most attention, and at 

 the present day there are still many who claim evidence of such 

 a manner of death. 



It may here be said that the standard for the size of the 

 thymus has been very unsatisfactory, and comparatively recent 

 work has shown that many glands which were accounted en- 

 larged were but normal. The old idea that the thymus dimin- 

 ished in weight from the second year of extra-uterine life is 

 now replaced by the certain knowledge that in normal indi- 

 viduals it increases in weight up to about the fifteenth year, 

 after which it normally undergoes gradual involution. The 

 thymus, however, suff'ers so severely as the result of nutritional 

 disturbances that it has been said that the condition of the 

 thymus is the best single indicator of the state of nutrition of 

 the body. This alteration in the thymus as the result of general 

 acute or chronic disease was termed "accidental involution" by 

 Hammar,(2) and the recognition of this has played a very im- 

 portant part in the interpretation of statistics. 



The evidence adduced to show that the thymus exerts suf- 

 ficient pressure to produce suflTocation is not all convincing and 

 Wiesel'sCS) conclusion that there may be a few cases dying from 

 this cause, while the majority are not thus accounted for, seems 

 justifiable. The fact that many infants who had large thymus 

 glands died with symptoms of stridor or laryngismus and pre- 

 sented on superficial anatomical examination little else to explain 

 the death is accountable for the importance attached to the 

 large thymus. As long ago as 1858, Friedleben(4) investigated 

 many of these cases and issued the dictum, "Es gibt kein Asthma 

 thymicum," but it remained for Paltauf in 1889(5) to promul- 

 gate the theory that the enlarged thymus was only one evidence 

 of a general vulnerable bodily constitution which he designated 

 "status lymphaticus." He described patients with this condi- 

 tion as exhibiting "great pallor of the skin, usually a well de- 

 veloped panniculus adiposus, more or less congested organs 

 without special changes in consistence; the spleen is mostly 



