98 THE INTERNAL SECRETIONS—1920 
Case II. An unmarried female, 29 years of age. 
Chief complaint, pain in the back, radiating down the 
thighs to the inner aspect of the knee. Pain absent 
during menstruation and markedly relieved by permit- 
ting herself to remain constipated for three days. 
These pains had commenced at her nineteenth year and, 
at times, were so violent as to incapacitate her for work. 
When she was twenty-seven years old both ovaries were 
removed (diagnosis: chronic odphoritis, cystic ova- 
ries). There had been no relief of the pain except for 
two months directly after operation. At present, she 
also complains slightly of the usual symptoms asso- 
ciated with the surgical menopause. 
Physical examination: Five pounds overweight, all 
refiexes extremely active, properly corrected error in 
ocular accommodation, pelvis negative except for ex- 
tremely sensitive areas in both lateral fornices. 
While therapeusis will be considered later it may be 
noted here that the pain was relieved by organothe- 
rapy. 
Case III. Married female, aged 42 years. For the 
past eight years she has suffered from a backache and 
what has been diagnosed as a chronic sciatica of the left 
leg. No treatment which had been applied relieved the 
pain in the back. The pain in the leg is intermittent 
and is always relieved at the establishment of men- 
struation. Menses normal up to two years ago; since 
then, irregular (over time) and profuse. She has four 
children alive and well. 
Physical examination: Overweight 28 pounds, 
marked hirsuties on lip and chin; mitral endocarditis; 
blood pressure 160 mm. systolic, 110 diastolic; abdo- 
men pendulous; lacerated cervix and perineum, the lat- 
ter supported by a properly-fitting pessary ; slight vari- 
cosities of right leg; moderate degree flat feet, sup- 
ported by properly fitted arches; mild secondary 
