IDEAS CONCERNING THE ENDOCRINES 267 
ous system was shocked by the experience more than 
the injury, and previously he had been very much 
overworked. He came to me without an acute symp- 
tom. I was unable to detect anything more than a 
“bankruptcy of nerve force,” as Osler has so forcibly 
called it, and conditions of hyposphyxia. [A condi- 
tion first described and named by Alfred Martinet of 
Paris, in which the chief symptom is lack of circula- 
tory tone with poor circulation, low tension, cold ex- 
tremities and venous stasis —H. R. H.] The blood 
pressure was low, both for the systolic and diastolic 
readings, and bradycardia was present, the pulse being 
fifty-six. Muscular weakness was apparent, and I 
wondered whether or not I had a permanent or a tem- 
porary myocardial condition to deal with. 
Under rest treatment, the tonics and the routine 
supportive hormone therapy, my patient gained in 
weight and strength. The heart is now beating sev- 
enty-eight to the minute, the muscular and nervous 
systems are approaching their balance, and my pa- 
tient will soon go back to work. 
One cannot accomplish the desired results in reédu- 
cating these hormone-producing glands in a_ short 
time, after they have been so seriously affected for so 
many weeks and by such virulent toxins; and one 
should not relegate valuable hormone therapy to obliv- 
ion without consistent and persistent efforts to obtain 
their effects for good. 
Two of my coworkers have corroborated my find- 
ings in numerous experiences, and it would be a use- 
less repetition to go on reporting such cases, especi- 
ally when there have been so many of them. 
ENDOCRINE THERAPY IN SURGERY 
Aside from the very practical value of the cases so 
briefly mentioned, I am going to make a plea for the 
balancing of these systems before operations are un- 
dertaken. One who has been in medical and surgical 
work for more than half of his life cannot but be im- 
pressed with the grave responsibilities of such work. 
