INTERRELATIONS OF SECRETIONS 53 



that they came on mostly at the time of, or just before, 

 the menses. There was no history of a blow on the 

 head or a fall, and she has been perfectly healthy until 

 two years ago. The nervousness was increasing, there 

 was no prominence or enlargement of the thyroid, the 

 urinary examination was negative. The mammae were 

 large and highly placed. 



She was given iron and arsenic, and some elixir or 

 triple bromides to be taken at times of worst nervous- 

 ness, and told to report at some future date. She re- 

 ported much improved but not entirely relieved. Four 

 months later she had a return of the symptoms, and 

 with an accentuation of the "nervous spells." The 

 mother was afraid to have the girl go out alone. A 

 diagnosis was made at this time of thyroid and ovarian 

 insufficiency and the patient put on a pluriglandular 

 combination. 



In two months the nervousness had disappeared, the 

 menses were increased and not so painful. More medi- 

 cation was sought and since that time (two more 

 months) , there has been no return of the symptoms. 



Applying the same thought to a later period in life 

 we see the various phenomena of the menopause with 

 the same nervousness*, but with a tendency towards 

 menorrhagia more often than not. The former usual 

 treatment was to give tonics like I. Q. & S. and variants. 

 (While this treatment is empirical, more or less, it is 

 not so unscientific as is generally supposed because of 

 the stimulus given to the endocrine organs by certain 

 drugs. Iodine and its action on the thyroid is gener- 

 ally known and arsenic has an action especially on the 

 hemopoietic organs.) The stimulus is insufficient when 

 drug tonics are given, and the alleviation of symptoms 

 is temporary and often practically nil. 



The same chain of organs is again at fault. This 

 time the stimulus of the ovary has begun to fail, where 

 it has played a large part in the economy and estab- 

 lished, since the time of puberty, a new balance. The 

 thyroid gland and ovary seem to need each other espe- 

 cially to establish and maintain this balance, which 



