VIII, B, 2 Crowell: Status Thymico-lymphaticus 79 



enlarged and shows prominent follicles; in the epiphyseal cart- 

 ilages are found evidences of active rachitic proliferation; the 

 follicles of the lymphatic glands are much enlarged and the 

 thymus well developed." He recognized the general lymphatic 

 changes which are present, and the cardiovascular hypoplasia, 

 and summarized the whole as evidence of a "lymphatic-chlorotic 

 constitution." The cause of death he considered to be due to 

 this anomalous constitution of the body, and the enlarged thymus 

 was for him but a symptom of that general nutritional disturb- 

 ance which was further evidenced by the enlarged lymphatic 

 glands, tonsils, etc. 



Bartel, (6) in Weichselbaum's laboratory, added another idea 

 in his conception of the lymphatic changes and those which he 

 found frequently associated with them as evidence of a "status 

 hypoplasticus" ; the associated changes found were anomalies of 

 development in other organs, as hypoplasia of the arterial system 

 and the genitalia, syringomyelia, hydrocephalus, glioma, and 

 frequently horse-shoe kidney, and embryonic lobulation of the 

 kidneys and lungs. 



Very few ideas have been added to those of Paltauf and Bartel 

 in the interpretation of the findings in such cases. The condi- 

 tions under which they are found, and the diseases with which 

 they are associated, however, have been much elaborated, and 

 some authors, especially Von Neusser, (7) have indicated certain 

 external appearances of the body which assist in making the 

 diagnosis clinically. 



This condition occurs in both infants and adults, although it 

 is more easily recognized in the latter class. It is now well 

 known that persons who are subjects of this condition have 

 a peculiarly vulnerable constitution and are liable to death from 

 seemingly insufficient causes. The cause of death in these cases 

 is still a matter of much discussion, but Paltauf's contention 

 that death is due to a paralysis of the heart is fairly generally 

 accepted. Shridde's(8) hypothesis that death is due to a kind 

 of endogenous poisoning through excessive or disordered func- 

 tion of the thymus Wiesel considers to be based on insufficient 

 evidence. Wiesel(9) himself has noted an hypoplasia of the 

 chromaffin system in cases of status lymphaticus, and this un- 

 doubtedly is an important element acting through the production 

 of diminished tone of vessels and nerves. 



All grades of the condition are found and are termed variously 

 status thymicus, status lymphaticus, status thymico-lymphaticus, 

 and partial status lymphaticus. It is possible and not improb- 



