146 THE INTERNAL SECRETIONS—1920 
While the toxemia causing hypertension may be gen- 
erated within the body, as was just mentioned in diph- 
theria or scarlet fever, it may come from outside as in 
lead-poisoning. The lack of certain glandular secre- 
tions also may cause hypertension. This is particularly 
noticeable after a double ovariectomy in a young 
woman or after the menopause in older women. Of 
course the obvious treatment is to supply the ovarian 
and allied principles to the patient. [Another not com- 
mon factor in bringing about a typically endocrine in- 
crease in the blood-pressure is concerned in the condi- 
tion known as “infiltration” which so uniformly accom- 
panied thyroid insufficiency. This theory has been quite 
fully outlined in a paper of my own, which will follow 
this essay.—H. R. H.] 
SUMMARY 
By way of summary, we should remember that hypo- 
tension is met with more frequently than hypertension. 
Hypotension, accompanied by muscular and cardiac 
atonia, generally is due to toxemia. The treatment con- 
sists of elimination by all the emunctories. Glandular 
products will form a part of the treatment, especially 
adrenal combinations or substance. Hypertension is 
due, in most cases, initially to toxemia, producing or- 
ganic changes in some organs as heart, blood vessels or 
kidneys. While the prospects of clinical results are not 
so good, elimination is the key to treatment, with prop- 
erly chosen organotherapy to retard excessive secretion 
of the adrenals or to modify the secretion of any gland 
as the thyroid, whose secretion may be stimulating the 
adrenals. 
