As Sajous[150] and we[151] also have shown in our already cited researches, that the various ductless glands are closely related, and thus changes in the thyroid are always accompanied by changes in the other ductless glands. This rule applies to the present case and after senile changes in the thyroid, with increase of connective tissue, the other ductless glands also show similar changes. These are found in the pituitary body, the adrenals, the liver, and kidneys. We have several times insisted upon this fact in various chapters of this book. Footnote 150: Sajous: Loc. cit. Footnote 151: Loc. cit. The adrenals of old people have been examined by Minervini,[152] and he found a true cirrhosis of these glands which had included nearly the whole gland. He also found drops of fat in the cells of the medulla. Dellamare[153] found a hypertrophic condition of this gland in old age. Footnote 152: Minervini: Journal d’anat. et de physiol., p. 449 and p. 639, 1904. Footnote 153: Dellamare: Soc. de biologie, 17 Octobre, 1903. In nature every cause has a sequel. Therefore, when we see such important changes in glands with internal secretions, there logically must be sequels to the alterations in these important organs. And these exist. When the thyroid is degenerated, to a greater or less extent all those symptoms appear which are characteristic of changes in the functions governed by the thyroid, and of which we have spoken in previous chapters. Therefore, when the thyroid is degenerated, symptoms appear which are characteristic of myxœdema. And, indeed, Sir Victor Horsley was the first to draw attention to the fact that in old age we find all the symptoms of myxœdema; and after him, Vermehren[154] and Ewald.[155] They have compared the symptoms of myxœdema with those of old age, and found the two conditions very similar. According to our own observations the most prominent of these corresponding symptoms are:— Footnote 154: Studier over Myxœdemet, Kjöbenhavn, 1895. Footnote 155: Ewald: “Die Erkrankungen der Schilddrüse,” Nothnagel’s Handbuch, Vienna, 1896. The wrinkles on the face and the drooping of the lower eyelids, in extreme cases amounting to ectropion. Then the great number of wrinkles on the hands of myxœdematous people, even at an early age, and the feeling of cold in the hands and feet and their bluish color. With advancing age, obesity is often the first symptom, just as in myxœdema, and, as we have said above, obesity can be caused by degeneration of the thyroid and sexual glands. The hair in both conditions is very often gray, and there is atrophy of the papillæ of the hair and of the sebaceous and sudorific glands, with dryness and falling out of the hair.