ADRENAL HYPOFUNCTION 157 
he wanted was to go to bed. This he did by 8.30 or 9 
P. M. and then would lie awake until 1 or 2 A. M. before 
he could go to sleep. Examination revealed no organic 
disease. Blood pressure systolic erect was 118 mm., 
recumbent 132, November 13th, 1919. Small doses of 
adrenal gland with thyroid, spermin and calcium gly- 
cerophosphate were given daily. Finally on January 
15th, 1920 he called me up and said, “I think you had 
better give me the once-over, Doctor.” When he came 
in, his systolic blood pressure was 118 mm. in the erect 
position, and 118 in the recumbent. I remarked that he 
ought to feel fine. He then said, “If people only knew 
what those capsules would do for them, they would be 
fighting for them with guns.” 
THE ETIOLOGY OF HYPOADRENIA 
Let us consider the causes of adrenal hypofunction. 
In the first place, we must bear in mind the fact that all 
people are not born with adrenals of the same state of 
development or functional efficiency. This idea has 
been worked out experimentally in hogs by Smith (7). 
He demonstrated that hypofunction of the thyroid in 
hogs is transmitted to their offspring. May we not then 
reason that adrenal hypofunction in the mother can be 
transmitted to her offspring because the thyroid, adre- 
nals and anterior pituitary are all a part of the ‘“‘adre- 
nal system” as first described by Sajous (8) and later 
by G. W. Crile (9)? 
The inherited cases are to me the chronic cases ac- 
cording to the classification of Emile Sergent (10). In 
my observation of Russian Jews I have so frequently 
found evidence of adrenal hypofunction that I have 
come to believe they all have it. I can readily under- 
stand this, for the Jews in Russia for generations have 
lived in fear of persecution (religious). Darwin (11) 
maintained long ago that acquired characteristics do 
become hereditary. Cannon and De La Pas (12) have 
