52 THE INTERNAL SECRETIONS—1920 
doubt, carry side chains of influence, much as nux 
vomica has other influences than strychnine. 
What has been accomplished by applying this know]- 
edge? First, there is a quick making up of the elements 
necessary to restore the balance. No matter if the thy- 
roid gland is most at fault, its stimulation on the other 
glands is no more necessary than the antostimulation 
of the others. Both synergists and inhibitory glands 
are stimulated to arrive at a balance, and the normal 
is approached more quickly if the secondary chain of 
glands is not far below par. When this is accomplished 
a single glandular extract (of thyroid, in the instance 
under discussion), will have to be given to keep up the 
balance, as this action cannot be restored in a gland 
that is absent or has never functioned. 
Further along in life we meet those cases which, 
while not actually myxedematous, are below par and in 
whom the ovarian response is below normal, due to 
lack of the thyroid principle. Here again a compound 
formula is preferably given in the form of an ovarian 
extract to make up deficiency and add its quota of auto- 
stimulation, which is supplemented with the well- 
known synergists or gonad function, thyroid and pitu- 
itary substance. When a balance has been established 
the chances of keeping the balance are greater than be- 
fore, as the thyroid now has the synergistic action of 
the ovaries. This deficiency gives rise to general lassi- 
tude, scanty menses, and nervousness. Often also 
there is chlorosis, dysmenorrhea and a tendency to- 
wards epileptiform attacks, simulating petit mal. The 
effect of a balanced extract is illustrated in the follow- 
ing case history. 
Miss M.N., age 16. A large, well-developed girl with 
some surplus flesh and no evident pallor of cholorosis, 
presented herself complaining of nervousness* and a 
tendency to fainting spells. These attacks were almost 
like a petit mal and alarmed her mother. It was noted 
