82 ENDOCRINE THERAPEUTICS 



as one would expect, the symptoms are aggravated. 

 This brings us to the possible use of the other 

 gland extracts, and the three principal ones are 

 adrenal, parathyroid, and pituitary. Adrenal 

 treatment has often been found beneficial, but 

 not infrequently a failure. This is explained, I 

 think, by a bad choice of cases. If the blood- 

 pressure is uniformly below the normal point, it 

 shows that there is adrenal deficiency, and it is 

 these cases that will respond to adrenal treat- 

 ment. Where the pressure is normal or above 

 it will not do good, but possibly harm. 



To my mind parathyroid is the chief gland 

 indicated. I give a short summary of para- 

 thyroid physiology from Bainbridge : " Our 

 knowledge of the function of the parathyroids 

 is derived almost entirely from observations on 

 the effects of the removal in animals or in men. 

 Extirpation of all four glands is followed in a day 

 or two by acute symptoms, which are for the most 

 part of nervous origin. The excitability of the 

 central nervous system is increased, and reflexes 

 are not only evoked more readily but are usually 

 more vigorous : tremors of the skeletal muscles, 

 and from time to time prolonged muscular spasms, 

 and even convulsions often occur. Since the 

 muscular twitchings and convulsions cease after 



