60 THE INTERNAL SECRETIONS—1920 
Two years ago she came to California from the East 
and attributes her changed state to the new climate. 
When coming here she weighed 118 pounds. The first 
four months she gained 30 pounds. During a severe 
attack of influenza she lost 18 pounds, but very soon re- 
covered her former weight. She has restricted her diet 
markedly, omitting the noonday meal and eating very 
little at morning and night. 
Physical examination showed a moderately obese girl 
with placid, unanimated face; color good; pulse 72 and 
regular; blood-pressure, systolic 1388, diastolic 70; 
hands were cold and dry; hair dry and lusterless; abdo- 
men, extremities, and chest negative. 
She was given thyroid extract and soon showed im- 
provement, becoming less drowsy and more amiable. 
She lost 12 pounds in two months though she did not 
restrict her diet as much as formerly. The menstrual 
flow was prolonged to three days and she always per- 
spired in a hot bath. She had to shampoo her hair 
oftener because of increased oiliness. The constipation 
was much relieved and she felt much better in every 
way. Objectively, she was more animated in movement 
and speech. The pulse and blood-pressure increased in 
proportion to the dosage. 
THYROID THERAPY OF OBESITY 
It is interesting to note that loss of weight is ob- 
tained in both the exogenous and endogenous types 
of obesity by the use of thyroid extract. This would 
indicate something in common between the two types, 
and suggests that the exogenous form of obesity is a 
metabolic disturbance also. This seems quite logical 
for if it is a simple mathematical problem to ingest a 
diet of greater caloric value than the expenditure of 
energy in calories, then it would be possible to cause 
anyone to put on weight. This we know from experi- 
ence is quite difficult to do in certain cases. We also 
