146 THE INTERNAL SECRETIONS 1920 



While the toxemia causing hypertension may be gen- 

 erated within the body, as was just mentioned in diph- 

 theria or scarlet fever, it may come from outside as in 

 lead-poisoning. The lack of certain glandular secre- 

 tions also may cause hypertension. This is particularly 

 noticeable after a double ovariectomy in a young 

 woman or after the menopause in older women. Of 

 course the obvious treatment is to supply the ovarian 

 and allied principles to the patient. [Another not com- 

 mon factor in bringing about a typically endocrine in- 

 crease in the blood-pressure is concerned in the condi- 

 tion known as "infiltration" which so uniformly accom- 

 panied thyroid insufficiency. This theory has been quite 

 fully outlined in a paper of my own, which will follow 

 this essay. H. R. H.] 



SUMMARY 



By way of summary, we should remember that hypo- 

 tension is met with more frequently than hypertension. 

 Hypotension, accompanied by muscular and cardiac 

 atonia, generally is due to toxemia. The treatment con- 

 sists of elimination by all the emunctories. Glandular 

 products will form a part of the treatment, especially 

 adrenal combinations or substance. Hypertension is 

 due, in most cases, initially to toxemia, producing or- 

 ganic changes in some organs as heart, blood vessels or 

 kidneys. While the prospects of clinical results are not 

 so good, elimination is the key to treatment, with prop- 

 erly chosen organotherapy to retard excessive secretion 

 of the adrenals or to modify the secretion of any gland 

 as the thyroid, whose secretion may be stimulating the 

 adrenals. 



