86 ENDOCRINE THERAPEUTICS 



given in full doses ; the least I give is J grain of 

 the dried extract, thrice daily, and we need not 

 hesitate to double the dose. 



Whole pituitary and thymus have been tried 

 in Graves' disease, sometimes apparently with 

 success, but I have no personal experience of 

 either of them. The best plan of treatment of 

 Graves' disease has hi my hands been as follows : 



(1) Find out by every means at one's command 

 the initial fault, and remove it as far as possible. 

 (Here X-ray examination will help much, so far 

 as abdominal faults are concerned.) 



(2) Rest. This can never be more than a 

 compromise ; the nervous affection is all against 

 it, and with a pulse rate of 120-140 it is more of 

 an aspiration than a reality ; but if by com- 

 parative rest the pulse rate can be lowered five 

 beats a minute, much is gained. 



(3) Suprarenal extract of the blood-pressure 

 is low, one grain of dried extract three or four 

 times a day. (This is about equivalent to the five 

 grain tablets of the fresh.) 



(4) Parathyroid always, in addition to anything 

 else one may be giving. Full doses are needed : 

 grain of dried extract three times a day is 

 generally sufficient, but this dose may be increased. 



Improvement should be noticeable in a week : 



