ay THE INTERNAL SECRETIONS—1920 
there was some loss of weight. I injected quinine and 
urea into the thyroid gland and prescribed anterior 
pituitary compound, one capsule to be taken daily for 
one week in each month. Taking the even small dose 
of thyroid (one twelfth of a grain) more frequently 
aggravated the symptoms and caused loss of weight, 
while using it intermittently with the pituitary had a 
beneficial effect. In six months the general symptoms 
were relieved, and the goitre reduced one third. She 
had gained 14 pounds in weight. 
Case 3.. W. T. C., aged 50, had a small goiter of 
eight years’ standing. It had caused no symptoms and 
had remained stationary in size until following an at- 
tack of influenza in January, 1919. At this time she 
came to my attention, suffering with toxic goitre, 
aggravated by the symptoms of the menopause. The 
pulse was 130, systolic pressure 150 mm., diastolic 
100 mm., temperature 100 deg. F., pains over both ovar- 
ies, marked insomnia, tremor, nervousness and loss of 
weight. Quinine and urea injections were given into 
the thyroid and the patient was placed on small doses 
of posterior pituitary and thyroid. This increased her 
symptoms and shortly after had to be discontinued. 
The thyroid alone was then tried, and this had to be 
abandoned also. Finally the anterior pituitary combi- 
nation was prescribed, one capsule to be taken daily, 
and she has gained in weight, her symptoms are re- 
lieved and the goitre has been reduced one third. 
Case 4. Mrs. B. F. M., aged 34, noticed that she was 
developing a goitre following parturition in 1914. She 
came to my attention in May, 1920, when she presented 
a small toxic goitre involving both lobes, together with 
symptoms of neurasthenia, headache, loss in weight, 
and fatigability. I prescribed posterior pituitary and 
thyroid. This aggravated the symptoms and I substi- 
tuted anterior pituitary compound, one dose to be taken 
twice daily. Under this treatment she has noticed a 
reduction in the goitre, and decided improvement in her 
general health, her headaches have disappeared and she 
has made a slight gain in weight. 
Case 5. Mr. D. C., aged 31, noticed goitre with severe 
exophthalmic symptoms four months previous to exam- 
ination March, 1920. During this time he had lost 35 
pounds in weight. Pulse 140, systolic pressure 145 mm., 
