INTERRELATIONS OF SECRETIONS 53 
that they came on mostly at the time of, or just before, 
the menses. There was no history of a blow on the 
head or a fall, and she has been perfectly healthy until 
two years ago. The nervousness was increasing, there 
was no prominence or enlargement of the thyroid, the 
urinary examination was negative. The mammae were 
large and highly placed. 
She was given iron and arsenic, and some elixir or 
triple bromides to be taken at times of worst nervous- 
ness, and told to report at some future date. She re- 
ported much improved but not entirely relieved. Four 
months later she had a return of the symptoms, and 
with an accentuation of the “nervous spells.” The 
mother was afraid to have the girl go out alone. A 
diagnosis was made at this time of thyroid and ovarian 
insufficiency and the patient put on a pluriglandular 
combination. 
In two months the nervousness had disappeared, the 
menses were increased and not so painful. More medi- 
cation was sought and since that time (two more 
months), there has been no return of the symptoms. 
Applying the same thought to a later period in life 
we see the various phenomena of the menopause with 
the same nervousness*, but with a tendency towards 
menorrhagia more often than not. The former usual 
treatment was to give tonics like I. Q. & S. and variants. 
(While this treatment is empirical, more or less, it is 
not so unscientific as is generally supposed because of 
the stimulus given to the endocrine organs by certain 
drugs. Iodine and its action on the thyroid is gener- 
ally known and arsenic has an action especially on the 
hemopoietic organs.) The stimulus is insufficient when 
drug tonics are given, and the alleviation of symptoms 
is temporary and often practically nil. 
The same chain of organs is again at fault. This 
time the stimulus of the ovary has begun to fail, where 
it has played a large part in the economy and estab- 
lished, since the time of puberty, a new balance. The > 
thyroid gland and ovary seem to need each other espe- 
cially to establish and maintain this balance, which 
