THOUGHTS ON INTERNAL SECRETION 205 
associated with enlarged follicles at base of tongue, are 
very apt to have an insufficiency of the medullary por- 
tion of the adrenals. The person whose pulse is difficult 
to find, because of a small artery, or whose uterus is of 
the infantile type, many times is deficient, in this re- 
spect. While I never heard it said by others, I have 
nearly always found an adrenal medullary insufficiency 
in persons whose pupils are chronically large. Such 
individuals have slight resistance to infection, and they 
are bad risks for the surgeon as well as the anesthetist. 
On the other hand, one will occasionally find an indi- 
vidual in whom it is quite difficult to dilate the pupil, his 
pulse is large and full, his blood pressure up to the top 
of normal, and, perhaps, his temperature is slightly 
above normal. Such an individual has an especially ac- 
tive chromaffin system, and his resistance is good. He 
will perhaps not die of an infectious disease, but rather 
of diabetes, nephritis, pernicious anemia or liver dis- 
ease. He takes an anesthetic splendidly, but may lose 
his life from the cocainization of a tooth for extraction. 
The possibilities of adrenal therapy are scarcely 
dreamed of as yet, even by the enthusiastic organothe- 
rapist. 
Sajous says that carcinomatous and sarcomatous 
growths in rats and mice have been made to disappear 
under adrenin treatment.® Solis-Cohen reports some 
wonderful results in the treatment of cardiac as well 
as true asthma;’ while Tyson and Jump claim to have 
cured abdominal ascites by the same medication.’ Per- 
sonally, I have seen marked improvement in bronchial 
asthma under combined pituitary and adrenal treat- 
ment; and in hay-fever I have known as much relief 
to follow an injection of Liquor Hypophysis as results 
from a quarter of a grain of morphia. 
As for thyroid extract, remember that it contains 
nature’s brand of iodine, as used in the metabolism of 
