260 THE INTERNAL SECRETIONS—1920 
five mils., until no reaction was found. He became 
conscious on the third day, took nourishment the fourth 
day, and following this time daily injections of mercury 
salicylate, one and a half grains, were given. In two 
months’ time the tumor disappeared, the liver dullness 
was nearly normal, and the patient was walking around 
and coming to the office for treatment. The potassium 
iodide was continued. The Wassermann has always 
been negative. He returned to work four months after 
beginning the treatment. He was accidentally injured 
six months later, with a septic infection, which resulted 
in death fifty-six hours afterward, though he was re- 
ported to have been in good physical condition during 
this time. Evidently the blood dyscrasia in this case 
was due to syphilis, though there was no Wassermann 
reaction at any time the test was made. 
ESSENTIAL POINTS IN THE TREATMENT 
It may be well to recapitulate some of the essential 
points that constitute this method of treatment. Rest 
in bed under as satisfactory circumstances as possible 
is imperative. A small amount of exercise often re- 
tards the progress made and prevents improvement, 
and this is easily proved in these cases by changing 
from rest to activity or vice versa. 
It is invariably necessary to assist digestion artifi- 
cially, since in pernicious anemia there is no hydro- 
chloric acid in the stomach and it has to be supplied 
from outside. 
Naturally, the conditions present in pernicious 
anemia do not favor very satisfactory endocrine activ- 
ity of the glands of internal secretion and products of 
this kind are particularly in order, especially from the 
thyroid and adrenal glands. One of the most success- 
ful remedies in my hands has been a compound capsule 
containing hemoglobin and its chief synergists. It is 
given in increasing doses until the physiological effect 
is pronounced. 
