260 THE INTERNAL SECRETIONS 1920 



five mils., until no reaction was found. He became 

 conscious on the third day, took nourishment the fourth 

 day, and following this time daily injections of mercury 

 salicylate, one and a half grains, were given. In two 

 months' time the tumor disappeared, the liver dullness 

 was nearly normal, and the patient was walking around 

 and coming to the office for treatment. The potassium 

 iodide was continued. The Wassermann has always 

 been negative. He returned to work four months after 

 beginning the treatment. He was accidentally injured 

 six months later, with a septic infection, which resulted 

 in death fifty-six hours afterward, though he was re- 

 ported to have been in good physical condition during 

 this time. Evidently the blood dyscrasia in this case 

 was due to syphilis, though there was no Wassermann 

 reaction at any time the test was made. 



ESSENTIAL POINTS IN THE TREATMENT 



It may be well to recapitulate some of the essential 

 points that constitute this method of treatment. Rest 

 in bed under as satisfactory circumstances as possible 

 is imperative. A small amount of exercise often re- 

 tards the progress made and prevents improvement, 

 and this is easily proved in these cases by changing 

 from rest to activity or vice versa. 



It is invariably necessary to assist digestion artifi- 

 cially, since in pernicious anemia there is no hydro- 

 chloric acid in the stomach and it has to be supplied 

 from outside. 



Naturally, the conditions present in pernicious 

 anemia do not favor very satisfactory endocrine activ- 

 ity of the glands of internal secretion and products of 

 this kind are particularly in order, especially from the 

 thyroid and adrenal glands. One of the most success- 

 ful remedies in my hands has been a compound capsule 

 containing hemoglobin and its chief synergists. It is 

 given in increasing doses until the physiological effect 

 is pronounced. 



