54 THE INTERNAL SECRETIONS—1920 
makes it hard to determine which is primarily at fault. 
It often takes the other organs three years to accom- 
modate themselves to this important change, and in the 
meantime the balance must be helped. The same com- 
bined extracts that enter into the normal sex stimulus 
here make up the deficiency. It has also been my ex- 
perience that the menorrhagia is controlled in most 
cases where there is no sign of tumor growth; and 
while roentgenology has a place in the treatment of 
these menorrhagias to control the hemorrhage, it mere- 
ly hastens the process of the menopause and does not 
help the nervous symptoms altogether. In fact, these 
are sometimes increased because the shock of quick 
withdrawal of the ovarian hormone influence is 
greater. Endocrine treatment should be given a trial 
before roentgen exposure is advised, and when this is 
done organotherapy should be used in conjunction with 
it to help the balance. The following two cases illus- 
trate the action from endocrine treatment, especially 
balanced treatment: 
Case 1. Mrs. E. E., age 41 (a relative) called a 
physician to her home for “flooding,” which was ac- 
companied by nervousness which had been ‘‘coming on 
lately.” He paid little attention to her lament and 
said that all women had it to go through, and showed 
such little attention that another physician was called 
in. Various agencies were called into play including 
ergot and vaginal packing, and an examination re- 
vealed a tumor that was causing the trouble, aug- 
mented, presumably, by the menopause. In time, an 
operation was performed. This was not satisfactory, 
as the surgeon gave an opinion that it was impossible 
to remove the tumor because of its being in such close 
relation to the large pelvic vessels. He told the patient 
that he had tied off some of the tumor vessels which 
would help it to absorb. In due time the tumor was 
found to be absorbing and then the patient was re- 
ferred to a roentgenologist to assist in completing the 
absorption. Many treatments were taken, and more 
were recommended, but the patient believed she did not 
