THE THYROID-OVARIAN SYNDROME 107 



As has been stated before, the key to successful or- 

 ganotherapy is a consideration and understanding of 

 physiology. The initial symptom of the ovarian type, 

 namely, backache, is possibly of purely mechanical 

 origin. The relief at the menstrual epoch makes it 

 seem probable that the pain is brought about by pres- 

 sure from within the organ which stretches the cap- 

 sule. The radiation of the pain is explainable by the 

 innervation, nevertheless, the persistence of pain after 

 oophorectomy is against such an explanation. 



The first symptom referable to dysfunction is a par- 

 tial loss of secondary sexual characteristics. The loss 

 of function as applied to the menstrual cycle is the last 

 to appear. Occasionally the organism makes a violent 

 attempt to keep up its function and this is clinically 

 manifested by a profuse menstruation. Finally the 

 menstrual stimulation becomes less and less and ame- 

 norrhea is the clinical manifestation. The ovary is in 

 intimate connection with the thyroid, a fact well known 

 to all. The pituitary relationship is just as evident, for 

 activity of the ovary (pregnancy) frequently is accom- 

 panied by an almost adenomatous proliferation of the 

 pituitary. 



The thyroid behaves in a manner somewhat analo- 

 gous to the ovary. The first insufficiency is one of de- 

 creased catabolic metabolism indicated by increase in 

 weight. As with the ovary, occasionally the gland, in 

 a final effort at compenstaion, works overtime and 

 nervous irritability, glycosuria, or temperature changes 

 may be the clinical result, just as these symptoms so 

 often are seen in atypical cases of Graves* disease. It 

 is probable, but not proved, that the normal thyroid to 

 some degree inhibits pituitary activity. When this 

 inhibition is removed, i. e., when there is thyroid dys- 

 function, there is hyperpituitarism indicated by high 

 blood pressure and headache. This is the reverse of 

 the ovarian type where hypopituitarism occurs as is 



