40 THE INTERNAL SECRETIONS—1926 
We must bear this in mind whenever we desire to 
institute organotherapy, and see that the patient is 
supplied with all those principles of internal secretion 
that his organism possibly may be in need of. 
It is to be hoped that the advances in physiological 
chemistry will provide us in the near future with cer- 
tain means for the detection of the different principles 
of the internal secretions in the blood, for they must 
absolutely be in order to exert their influence on the 
organism. At that time we will also be able to diag- 
nose precisely which particular gland is causing the 
trouble in a given case, as its comparative hypo- or 
hyper-activity, for then we shall be able to demonstrate 
its dysfunction in a scientific manner by determining a 
decreased or increased amount of its active principle 
in the blood. But until this is possible, we must have 
recourse to the method known as pluriglandular the- 
rapy in order to give the organism a chance to select 
and make use of what may be lacking. 
Occasionally we find cases where the deficiency of a 
certain single gland is well manifested, and in such 
instances monoglandular therapy directed to the one 
gland in question largely fulfills the indication. 
The following cases, some of them still under my ob- 
servation, have convinced me of the efficacy of the 
glands of internal secretion as therapeutic measures in 
certain instances. 
CASE No. 1. A young man of 26, fairly well developed 
physically, and a butcher by occupation, consulted me 
for extreme weakness. About 2 P. M. he said he is all 
played out, although he never works very hard. His 
family history and past medical history are negative. 
The physical examination revealed nothing abnormal 
except that his blood pressure was remarkably low for 
his age, the systolic pressure being 100 mm. and the 
diastolic only 55 mm. 
On the assumption that the patient was not getting 
enough of the adrenal secretion, the dried adrenal 
