The absorption and utilization of nutriment by a voluntary muscle is evidently dependent on the impulse conveyed in its motor nerve. Without that impulse, as after section and degeneration of the nerve, the muscle atrophies. The impulse, of course, performs its function, which thus must be, at least in part, trophic, at the distal extremity of the nerve or its end-plate. This, when the trunk of the nerve has been irritated by repeated electric shocks, can be readily made to cease functionation because of fatigue. When its onset is indicated by the decreasing contractions of the muscle, the intravenous injection of extracts of the thyroid, parathyroid and adrenal glands will immediately reinvigorate the failing contractions.1 If, however, the fatigue of the end-plate is carried to the point of exhaustion, then these extracts become inert. In other words, the thyroid, parathyroid and adrenal glands probably pour into the circulation some material
ROGERS J. FATIGUE DISEASE: AS EXEMPLIFIED IN FUNCTIONAL DISORDERS OF THE STOMACH AND THYROID GLAND. Arch Intern Med (Chic). 1919;23(4):498–510. doi:10.1001/archinte.1919.00090210092007
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