RT Journal A1 Krauthammer C, Klerman GL T1 SEcondary mania-reply JF Archives of General Psychiatry JO Archives of General Psychiatry YR 1979 FD August 1 VO 36 IS 9 SP 1031 OP 1031 DO 10.1001/archpsyc.1979.01780090117016 UL http://dx.doi.org/10.1001/archpsyc.1979.01780090117016 AB In Reply.—  Our omission of mania secondary to thyrotoxicosis stems not from any rejection of the possibility of such an entity but rather from our inability to find in the literature a well-described case that lacked confusional symptomatology. Drs Villani and Weitzel's case appears to meet the criteria for secondary mania and thus adds further support to our theory of multiple causation, by providing an example of yet another—this time endocrinological—pathophysiology. It also supports our belief that once secondary mania is given some nosological legitimacy, more cases will be sought and found, adding data for further theoretical and experimental explorations of the causes of mania.