152 ENDOCRINE GLANDS 



2. TREATMENT OF THE PAINS AND GASTRO IN- 

 TESTINAL DISTURBANCES. The pains are sometimes 

 severe enough to require local treatment. Counterirrita- 

 tion is preferable to an analgesic, for all toxic medication 

 must be given with extreme care in Addison's disease. 



If the vomiting is not improved by organo therapy 

 counterirritation in the pit of the stomach will help. 

 Sometimes chloroform water or cocaine will prove to 

 be beneficial. 



3. GENERAL AND HYGIENIC TREATMENT. This is 

 very important. These patients must avoid all fatigue. 

 The slightest infection may be the starting point of severe 

 symptoms of adrenal insufficiency. The usual diet of 

 tuberculous patients is advised for these patients. Arsenic, 

 often given in tuberculosis, must, however, be avoided or 

 only given very cautiously. Phosphates are supposed to 

 be beneficial. 



III. MILD ADRENAL INSUFFICIENCY. 



This condition corresponds to an attenuated adrenal 

 secretion and may be due to many causes. 



The various clinical manifestations are as follows : 

 1. In tuberculosis; mild adrenal insufficiency explains: 

 (a) The asthenia of certain patients, out of proportion 

 to the tuberculous lesions. 



(6) The hypotension which is so often seen and which 

 has been so much insisted upon by such clinicians as 

 Marfan, Potain, Teissier and which must be taken into 

 account in the prognosis. 



(c) The evolution of the tuberculosis. Sergent, starting 

 from the hypothesis that recalcification is an important 

 factor in tuberculosis and having shown that adrenal 

 extract is a powerful adjunct to recalcification, concludes 



