8o ENDOCRINE THERAPEUTICS 



scarcely covers the whole ground. There must 

 be, I think, functional disorder as well as func- 

 tional increase. 



Then, again, the same toxaemia that produces 

 these manifest signs must inevitably affect other 

 endocrines, and this may be in the direction of 

 stimulation or of inhibition. We find in some 

 cases plus arterial pressure and in some minus 

 pressure ; this points to the adrenal system 

 suffering in one way or the other ; but, I think, we 

 must look to the parathyroids mostly. Here all 

 points to their deficiency, or almost to suppression. 

 These glands are the chief thyroid controllers, 

 and when they are not in action the thyroid 

 engine races. In other directions we see evidences 

 of parathyroid suppression ; the nervous tremor 

 of the limbs suggests that of tetany, which follows 

 extirpation of these glands. The wasting and 

 increased metabolism both point to the thyroid 

 check being out of work. In fact, to be accurate, 

 we must look on Graves' disease from one point 

 of view as hyperthyroidism and hypoparathy- 

 roidism combined. This idea will help us in the 

 practical treatment of the urgent symptoms, it 

 may help us to make a break in the vicious chain, 

 but it does not help us to the cause, the original 

 toxaemia. In many cases there is a report or 



