THYROID INSUFFICIENCY 61 



more common type is the man who, about 50, 

 begins to get short-winded, to get fatigued in 

 body and brain on insufficient cause, to get 

 occasional vertigo perhaps, and insomnia. Care- 

 ful observation will show an uniform rise of pres- 

 sure and often slightly dilated heart ; in this 

 early stage there is usually no albuminuria. If 

 one can get hold of these cases early one can cure 

 them, for true sclerosis has not come on. 



In women about the menopause the same trouble 

 often occurs ; indeed, every woman, I think, has 

 a rise of pressure at this tune. In quiet-living 

 healthy folk the condition may be only temporary, 

 but in some cases it may be the beginning of true 

 hyperpiesis. Therefore I strongly advise that 

 every man and woman should at 50 and after- 

 wards get their blood-pressure tested from time 

 to time : so much can be done in the day of small 

 things ; such tragedies wait on neglect. 



The reader will perhaps ask what has this got 

 to do with endocrine therapy ? Much every way. 

 In all these cases the thyroid has partially struck 

 work, and with this more or less the other endo- 

 crines have followed suit. I am not arguing that 

 the thyroid is the first offender ; the causes lie 

 beyond and in many directions, but the thyroid 

 shows the earliest symptoms of altered function 



