HYPOTHYROIDISM AND HYPERTENSION 151 



through these finest capillary meshes? In this connec- 

 tion we recall very well that another of the commonest 

 symptoms of hypothyroidism is a tendency to cold 

 hands and feet. The circulation of the remoter parts 

 of the body is very much below par, and this I believe to 

 be due to exactly the same cause as the infiltration that 

 already has been mentioned. 



I think that we have reasoned out a relation between 

 the infiltration of thyroid insufficiency and a decreasing 

 of the size of the precapillary vessels and this I believe 

 to be an important mechanical factor in the cause of 

 hypertension. It is granted that the other toxic influ- 

 ences which would naturally accompany so serious a 

 change in the general cellular chemistry must exert 

 their influence also, and it is presumed that they do so 

 through their effects upon the adrenal mechanism and 

 its control of the circulatory muscular tone, including 

 that of the heart itself. If we are successful in our 

 thyroid therapy of the minor forms of hypothyroidism 

 we will notice quite a change in this infiltration and its 

 results. Many symptoms of a semimechanical nature 

 are reduced. The cells are enabled to throw off a good 

 deal of the effete material and there is a consequent in- 

 creased chemistry as indicated by the urinary findings 

 and a loss in weight due to the removal of much of the 

 infiltrated effete material. This being the case there 

 is a change in the nutrition of these infiltrated areas, 

 and the skin (and other tissues) assumes a more 

 healthy appearance; the work of the various organs, 

 which heretofore have been puffy, soggy, and infil- 

 trated, is more nearly normal; the circulation is in- 

 creased and this mechanical factor, which I contend is 

 a part of the cause of the high blood pressure, automati- 

 cally is reduced. 



In other words, thyroid therapy in cases of hypothy- 

 roidism with high blood pressure not merely removes 

 a part of the accumulated toxemia but at the same time 



