CLINICAL ASPECTS OF ENDOCRINOLOGY 25 
partum attacks led the examiner to increase the meta- 
bolic activity, with the result that within two weeks the 
attacks disappeared, and a second blood examination 
showed her blood sugar to be 125 mg., urea 16 mg., and 
kreatinin .28 mg. Was the primary condition an unsta- 
ble thyroid brought into activity by pregnancy, or was 
it the toxico-biochemical changes affecting the nervous 
mechanism of the cardiovascular system? 
A somewhat similar reaction was seen in a woman of 
27 years, who gave birth to a child five months ago, and 
who, since then, has been unable to cope with her house- 
hold duties. She has grown stout and complains of 
being weak and tired, with attacks of sweating, with 
cold hands and feet. Her systolic blood pressure was 
90 mm., with a rapid, irregular pulse. There was a 
double systolic blow over the heart. In her history we 
find that she has always been anemic and nervous. She 
had an attack of ‘“‘nervousness”’ five years ago, with pal- 
pitation of the heart, frequent nosebleed, and erythro- 
malgia. After her marriage she gained in weight. Her 
urine examination was negative. The blood examina- 
tion showed a blood sugar of 140 mg., a urea of 16 mg., 
non-protein nitrogen of 37 mg., and kreatinin of .18 
mg. In this case all her complaints developed following 
her pregnancy, and are related to the cardiovascular 
system in an individual whose vascular system has been 
“conditioned” undoubtedly. Is this conditioning pri- 
marily an organic inferiority or a disturbance in the 
neurogenic mechanism with disturbances in metabol- 
ism? 
THE ENDOCRINE GLANDS 
The third system to be considered is the chain of 
endocrine glands. Histologically they are composed of 
secretory cells, supportive tissues and an extensive 
blood supply, which is under both the autonomic and 
sympathetic control. When there is an actual disturb- 
