74 ENDOCRINE THERAPEUTICS 



the vis a tergo, but far more by vaso-dilation, that 

 is, by the lowering of the gradients in front. 



Another great help to thyroid in bringing down 

 pressure is hippuric acid in the form of hippurate 

 of lithia or soda ; introduced by the late Dr. 

 George Oliver, of Harrogate, it has in a fair 

 number of cases a very rapid action, and one far 

 more lasting than that of the nitrites. Where 

 there is no arterial thickening and the tension 

 may be said to be only functional, it will work 

 quite well without any thyroid at all, but I use 

 it chiefly as an aid to the gland. It was originally 

 made from the urine of any graminivorous 

 animal, such as the horse or cow, but it is now 

 made synthetically. No accurate solution of its 

 physiological action has, I believe, been made 

 so far, but I think it will be found that it hastens 

 and helps the elimination of waste nitrogenous 

 material by the kidneys. I hope I may be 

 excused for giving a personal example. I belong 

 to a sclerotic family, and always take my com- 

 pound thyroid tablets : a few days ago I was 

 feeling my head stupid, rather giddy, and the 

 heart was painful. I found that my pressure was 

 180 mm. ; this is much above my average. In 

 addition to my thyroid I took 9 grains of lithium 

 hippurate (in 3'grain doses) daily for three days ; 



