224 THE INTERNAL SECRETIONS—1920 
In combating the numerous disorders which ac- 
company the menopause, from first to last, ovarian 
medication is indicated and, of course, any other neces- 
sary medication compatible with it. There are three 
ovarian preparations available: total ovarian extract, 
extract of the corpus luteum, and ovarian residue. The 
second is indicated chiefly in cases presenting disturb- 
ances of the menstrual function only. As these are 
not usual at the menopause, extracts of the whole 
gland should be used, and the desiccated extracts are 
to be preferred. Each case, of course, should receive 
minute study to determine just what endocrine re- 
quirements exist. 
The majority of cases suffer from hyperadrenia. 
But adrenal therapy may be given for the rare con- 
dition asthenia, pigmentation, and hypoadrenia. Mrs. 
W. illustrates the latter—40 years of age. She com- 
plained of epigastric pain an hour after eating, some 
nausea and great weakness; was badly constipated 
and had some hot flashes, though her periods were 
still fairly regular. She had had the “flu” five months 
previously and had lost some weight, but had never 
been well since the birth of her last baby five years 
ago. Family, past history and physical examination 
negative except for a low blood pressure. She had 
been in the County Hospital where her stomach con- 
tents had been examined three times. She was given 
ovarian substance, two grains; thyroid, one grain; 
adrenal, one grain; one capsule t.i.d. In a week she re- 
ported feeling much better, and in two weeks went 
out and got a job to help support her three children 
and drunken husband. 
In any of these disorders it must be remembered 
that ovarian pain is rarely the fault of the ovary. In 
this connection Chipman" recalls the words of La 
Rochefoucauld, ‘‘Pain is the biggest liar in the world.” 
