The Renal Blood Flow 103 



the early fluctuating phase of essential hypertension is a 

 manifestation of a psychoneurosis based on excessive and in- 

 hibited hostile impulses;^ and again, that inhibition of hetero- 

 sexuality or repression by a dominant mother, with chronic 

 hostile but unsuccessful rebellion against submissiveness, are 

 common psychological features of the disease.^^ 



Therapy is frequently a guide to etiology; and we may 

 note that high blood pressure (and too frequently only high 

 blood pressure) has been optimistically treated by herbals, a 

 diet poor in meat or poor in salt, by extraction of teeth or 

 tonsils, by high colonic irrigation, by abstinence from alco- 

 hol, tobacco, coffee and tea, by systematic relaxation, by in- 

 jection of various endocrines, by excision of part or nearly 

 all of the autonomic nervous system, by a variety of drugs 

 (with usually no knowledge whether these drugs act upon 

 the heart, the arterial or the venous circulation) , and last but 

 not least in efficacy, by simple suggestion. One should not too 

 quickly deprecate any of these efforts: rational medicine has 

 ample reason to respect quasi-empirical therapy after some 

 recent experiences. And as a physiologist' having no thera- 

 peutic axe of my own to grind, I am not concerned whether 

 the herbalist, the surgeon or the psychoanalyst comes out first 

 in this therapeutic competition, though I am, of course, de- 

 lighted that each one has achieved a modicum of success. 



In the present state of our knowledge, it would be haz- 

 ardous to advance the kidney as more than one contributor 

 to a malignant Tnelange which, if we are to accept a fraction 

 of the evidence, is a constitutional disorder involving in ad- 

 dition to the kidneys, the vascular bed, the vasomotor cen- 

 ters, the cerebral cortex, perhaps the entire organism and its 

 genetic foundations. And yet, considering the tentative na- 



