38 THE INTERNAL SECRETIONS—1920 
But there is a group of structures in the human or- 
ganism whose functions are not as well understood, be- 
cause their activities are not as readily observable 
under normal conditions. We do, however, recognize 
definite changes produced in the well-being of the indi- 
vidual by a hypo- or hyper-function of one or more 
of these structures. They are the so-called glands of 
internal secretion, including the hypophysis, the thy- 
roid, the parathyroids, the thymus, certain parts of the 
pancreas, the spleen, the adrenals, the ovaries, the tes- 
ticles, the prostate and perhaps others. It is these 
structures to which our attention should be directed 
when we think of the above-mentioned phenomena. 
Especially must we concentrate our investigation on 
these structures as being the possible cause of the trou- 
ble, when conditions, such as have been mentioned 
above, become marked in the absence of any chronic 
infection or affection, such as tuberculosis, chronic kid- 
ney disease, organic heart disease, etc. 
In all such or similar cases the first step toward a 
rational treatment is to correct errors in diet as well as 
in the mode of living, and to remove all sources of in- 
fection, if such be found and their removal is possible. 
If these hygienic measures fail to bring about an im- 
provement in the condition, it is only logical to assume 
that some one or more of the glands of internal secre- 
tion are at the bottom of the trouble; and then we 
must, by virtue of necessity, turn our attention to these 
glands and try to find out which particular gland or 
glands are at fault, and also to determine the character 
of the fault, 7. e., whether they are secreting too much 
or not enough for the organ. We can then institute our 
treatment accordingly. In cases of the first instance 
the oversecretion will have to be checked, either by 
drugs tending to inhibit such action, or by the removal 
of a smaller or larger part of the gland in question. In 
the second instance, the administration of the active 
