52 THE INTERNAL SECRETIONS 1920 



doubt, carry side chains of influence, much as nux 

 vomica has other influences than strychnine. 



What has been accomplished by applying this knowl- 

 edge ? First, there is a quick making up of the elements 

 necessary to restore the balance. No matter if the thy- 

 roid gland is most at fault, its stimulation on the other 

 glands is no more necessary than the antostimulation 

 of the others. Both synergists and inhibitory glands 

 are stimulated to arrive at a balance, and the normal 

 is approached more quickly if the secondary chain of 

 glands is not far below par. When this is accomplished 

 a single glandular extract (of thyroid, in the instance 

 under discussion) , will have to be given to keep up the 

 balance, as this action cannot be restored in a gland 

 that is absent or has never functioned. 



Further along in life we meet those cases which, 

 while not actually myxedematous, are below par and in 

 whom the ovarian response is below normal, due to 

 lack of the thyroid principle. Here again a compound 

 formula is preferably given in the form of an ovarian 

 extract to make up deficiency and add its quota of auto- 

 stimulation, which is supplemented with the well- 

 known synergists or gonad function, thyroid and pitu- 

 itary substance. When a balance has been established 

 the chances of keeping the balance are greater than be- 

 fore, as the thyroid now has the synergistic action of 

 the ovaries. This deficiency gives rise to general lassi- 

 tude, scanty menses, and nervousness. Often also 

 there is chlorosis, dysmenorrhea and a tendency to- 

 wards epileptiform attacks, simulating petit mal. The 

 effect of a balanced extract is illustrated in the follow- 

 ing case" history. 



Miss M. N., age 16. A large, well-developed girl with 

 some surplus flesh and no evident pallor of cholorosis, 

 presented herself complaining of nervousness* and a 

 tendency to fainting spells. These attacks were almost 

 like a petit mal and alarmed her mother. It was noted 



