SPHYGMOMANOMETER AND ENDOCRINES 145 



In these organic cases, while the blood pressure may not 

 be so high as in the functional type generally, yet the 

 prognosis is grave so far as a complete clinical cure is 

 concerned and with a large number of these patients, 

 the organic condition is a menace to life. 



The aim of treatment must be directed to the ameli- 

 oration of the symptoms and the comfort of the patient. 

 Drugs are of some value it is true, yet while not prom- 

 ising to do the impossible, organotherapy will do 

 wonders in some of these cases in alleviating condi- 

 tions. Each case must be studied individually, and the 

 glandular products chosen accordingly; on the other 

 hand a renal case may be benefited by renal organo- 

 therapy, while, on the other, antagonism to adrenal 

 hypersensitiveness by pancreas substance may be just 

 the thing. As time elapses better and better results 

 from the endocrines are to be expected in treating cases 

 of hypertension. 



*~When we undertake the study of a case of hyperten- 

 sion of functional origin, we can do so with the greatest 

 assurance of success for we are dealing with a condi- 

 tion the cause of which we have a better chance of 

 removing, and this is generally a toxemia cellular, 

 alimentary or dietetic; while in the hypertensive case 

 with an organic basis, we are dealing with a morbidly 

 changed anatomy, which can be restored toward the 

 normal only in a degree. Of course we must recognize 

 the fact that functional cases may go on for a longer 

 or shorter time and morbid changes may take place 

 which will put these cases into the organic class. In 

 passing, we might say that the probability is, if we 

 are able to trace the trouble back to the beginning in 

 all the cases of organic hypertension, we should find 

 that it began initially in a toxemia as, for instance, the 

 bacterial toxema of diphtheria or scarlatina which re- 

 sulted later in a nephritis. 



