CLINICAL ASPECTS OF ENDOCRINOLOGY 25 



partum attacks led the examiner to increase the meta- 

 bolic activity, with the result that within two weeks the 

 attacks disappeared, and a second blood examination 

 showed her blood sugar to be 125 mg., urea 16 mg., and 

 kreatinin .28 mg. Was the primary condition an unsta- 

 ble thyroid brought into activity by pregnancy, or was 

 it the toxico-biochemical changes affecting the nervous 

 mechanism of the cardiovascular system? 



A somewhat similar reaction was seen in a woman of 

 27 years, who gave birth to a child five months ago, and 

 who, since then, has been unable to cope with her house- 

 hold duties. She has grown stout and complains of 

 being weak and tired, with attacks of sweating, with 

 cold hands and feet. Her systolic blood pressure was 

 90 mm., with a rapid, irregular pulse. There was a 

 double systolic blow over the heart. In her history we 

 find that she has always been anemic and nervous. She 

 had an attack of "nervousness" five years ago, with pal- 

 pitation of the heart, frequent nosebleed, and erythro- 

 malgia. After her marriage she gained in weight. Her 

 urine examination was negative. The blood examina- 

 tion showed a blood sugar of 140 mg., a urea of 16 mg., 

 non-protein nitrogen of 37 mg., and kreatinin of .18 

 mg. In this case all her complaints developed following 

 her pregnancy, and are related to the cardiovascular 

 system in an individual whose vascular system has been 

 "conditioned" undoubtedly. Is this conditioning pri- 

 marily an organic inferiority or a disturbance in the 

 neurogenic mechanism with disturbances in metabol- 

 ism? 



THE ENDOCRINE GLANDS 



The third system to be considered is the chain of 

 endocrine glands. Histologically they are composed of 

 secretory cells, supportive tissues and an extensive 

 blood supply, which is under both the autonomic and 

 sympathetic control. When there is an actual disturb- 



