194 THE INTERNAL SECRETIONS 1920 



phenomena of melancholic type, incident upon puberty, 

 are quite noticeable among school girls. Small and long- 

 continued doses of thyroid improve the mental condi- 

 tion of these children. After a period of two years of 

 treatment they enjoy a fair degree of mental health 

 and activity. 



In hyperthyroidism, on the other hand, we may find 

 the active manias and neurasthenias, sympatheticotonic 

 and vagotonic irritability, while, as a result of dyspi- 

 tuitarism we see sexual infantilism, apathy, backward- 

 ness, lack of ambition and inability to do ordinary 

 work. In the former, I get good results from Crotti's 

 pancreas combination, thyroidectin and quinine hydro- 

 bromide and in the latter with pituitary preparations. 



In those suffering from ovarian and testicular dis- 

 turbances we get sexual perversion, mental disorders, 

 erotomania and active or depressed mania. The men- 

 strual periods have special bearing upon the metabol- 

 ism and mental forces. In these disorders they im- 

 prove on organotherapy, such treatment being insti- 

 tuted according to the predominating symptoms in the 

 individual case. The study and practice of the treat- 

 ment of psychiatry of insane cases in institutions and 

 its relation to internal secretions and metabolism de- 

 serves a great deal of attention. Much can be done 

 along these lines for children before puberty, which 

 will help to prevent these psychic disorders later on. 

 Dr. Sajous found that 65 per cent of all idiots are de- 

 prived of their thymus before six years of age. 



Hyperparathyroidism is believed to be a cause of 

 myasthenia paralytica (Chvostek) and of the rarer 

 condition known as myotonia periodica. Thyroid and 

 parathyroid therapy helps here. Parathyroid insuffi- 

 ciency induces trophic disturbances of the skin, nails 

 and hair; myotonia, myoclonia, tetany, myoclonic con- 

 vulsive movements and epileptic seizures. These cases 

 do exceptionally well on an anterior pituitary combina- 



