SPHYGMOMANOMETER AND E\NDOCRINES 145 
In these organic cases, while the blood pressure may not 
be so high as in the functional type generally, yet the 
prognosis is grave so far as a complete clinical cure is 
concerned and with a large number of these patients, 
the organic condition is a menace to life. 
The aim of treatment must be directed to the ameli- 
oration of the symptoms and the comfort of the patient. 
Drugs are of some value it is true, yet while not prom- 
ising to do the impossible, organotherapy will do 
wonders in some of these cases in alleviating condi- 
tions. Each case must be studied individually, and the 
glandular products chosen accordingly; on the other 
hand a renal case may be benefited by renal organo- 
therapy, while, on the other, antagonism to adrenal 
hypersensitiveness by pancreas substance may be just 
the thing. As time elapses better and better results 
from the endocrines are to be expected in treating cases 
of hypertension. 
~ When we undertake the study of a case of hyperten- 
sion of functional origin, we can do so with the greatest 
assurance of success for we are dealing with a condi- 
tion the cause of which we have a better chance of 
removing, and this is generally a toxemia—cellular, 
alimentary or dietetic; while in the hypertensive case 
with an organic basis, we are dealing with a morbidly 
changed anatomy, which can be restored toward the 
normal only in a degree. Of course we must recognize 
the fact that functional cases may go on for a longer 
or shorter time and morbid changes may take place 
which will put these cases into the organic class. In 
passing, we might say that the probability is, if we 
are able to trace the trouble back to the beginning in 
all the cases of organic hypertension, we should find 
that it began initially in a toxemia as, for instance, the 
bacterial toxema of diphtheria or scarlatina which re- 
sulted later in a nephritis. 
