54 THE INTERNAL SECRETIONS 1920 



makes it hard to determine which is primarily at fault. 

 It often takes the other organs three years to accom- 

 modate themselves to this important change, and in the 

 meantime the balance must be helped. The same com- 

 bined extracts that enter into the normal sex stimulus 

 here make up the deficiency. It has also been my ex- 

 perience that the menorrhagia is controlled in most 

 cases where there is no sign of tumor growth; and 

 while roentgenology has a place in the treatment of 

 these menorrhagias to control the hemorrhage, it mere- 

 ly hastens the process of the menopause and does not 

 help the nervous symptoms altogether. In fact, these 

 are sometimes increased because the shock of quick 

 withdrawal of the ovarian hormone influence is 

 greater. Endocrine treatment should be given a trial 

 before roentgen exposure is advised, and when this is 

 done organotherapy should be used in conjunction with 

 it to help the balance. The following two cases illus- 

 trate the action from endocrine treatment, especially 

 balanced treatment: 



Case 1. Mrs. E. E., age 41 (a relative) called a 

 physician to her home for "flooding," which was ac- 

 companied by nervousness which had been "coming on 

 lately." He paid little attention to her lament and 

 said that all women had it to go through, and showed 

 such little attention that another physician was called 

 in. Various agencies were called into play including 

 ergot and vaginal packing, and an examination re- 

 vealed a tumor that was causing the trouble, aug- 

 mented, presumably, by the menopause. In time, an 

 operation was performed. This was not satisfactory, 

 as the surgeon gave an opinion that it was impossible 

 to remove the tumor because of its being in such close 

 relation to the large pelvic vessels. He told the patient 

 that he had tied off some of the tumor vessels which 

 would help it to absorb. In due time the tumor was 

 found to be absorbing and then the patient was re- 

 ferred to a roentgenologist to assist in completing the 

 absorption. Many treatments were taken, and more 

 were recommended, but the patient believed she did not 



