266 THE INTERNAL SECRETIONS—1920 
Coquette.” This term, indeed, conveys a very vivid 
and familiar clinical picture. 
The terrible depression of this condition is the one 
outstanding symptom, and, in many cases, it is the 
pathognomonic feature with which we must deal. 
Sajous, Harrower and other authorities have found 
that hypoadrenia is present in severe infections, and 
compound organotherapy directed to the necessary 
support of the depleted glands is the rational treat- 
ment for such cases. Especially is this true in the light 
of my previous statements. 
Illustrative of the points in question, I desire to re- 
port the following case: 
Miss B., a Russian, aged 32 years, had been sick 
with “flumonia’”’ and had been in the hospital and sent 
home no less than three times. She did not get proper 
consideration along the lines which the clinical evi- 
dence suggested, for when I saw her she was still suf- 
fering from cough, temperature, hyposphyxia, muscu- 
lar asthenia, nervous exhaustion and a near approach 
to melancholia. She had to be held up in bed in order 
to be examined. [ found an unresolved lobar pneu- 
monia and the sequelae of influenza which I have enu- 
merated. 
Before mentioning the treatment of this case I wish 
to emphatically state that accurate diagnosis suggests 
accurate therapy, and that the right synergists will 
make the difference between failure and success in 
many cases. A microscopical analysis of the sputum 
in this instance showed the need of the mixed respira- 
tory vaccines. The general asthenia was the index 
for tonics and reconstructives, such as the triple ar- 
senates with strychnia. 
A pleasant environment, good diet, massage and a 
six weeks’ course of supportive pluriglandular therapy 
reestablished the balancing of the circulatory, mus- 
cular and nervous systems, and their allied coworking 
organs. Under this plan this patient entirely recov- 
ered, although when first seen she was very nearly 
over the line of insanity. 
Mr. U., American, grocer, age 36 years, had influ- 
enza; was in an automobile wreck in which his nerv- 
