OVARIAN THERAPY 155 



subjective symptoms as vertigo and nausea, so often complained of by 

 patients taking desiccated gland by mouth, are seldom noted following 

 injections of the soluble extract. He looks upon headache as the chief 

 manifestation of overdosing by the soluble extract, The results are more 

 rapid than by the ingestion method, which may be resorted to once im- 

 provement is begun by the injection method. 



Ovarian Residue. Recently Graves (a) (&) has suggested the use of a 

 substance representing the residue of the ovary after removal of the cor- 

 pora lutea, The basis of this is his belief that the chief source of the inter- 

 nal secretion of the ovary is in the interstitial cells. He believes that the 

 results of treatment of various conditions by this ovarian residue are 

 superior to those obtained from the use of whole ovary or of corpus 

 luteum alone. Tyler has reported good results from this form of therapy, 

 as has also Clagett. It is as yet too soon, however, to decide whether the 

 use of this substance will yield results which are better than, or perhaps 

 as good as, the older methods of medication. Ovarian residue, it may be 

 added, is obtainable not only in solid form but also in solution in the 

 form of ampoules. 



Physiologic Action of Ovarian Extract 



Comparatively little work of a really scientific nature has been done 

 on the physiologic effects of the various ovarian extracts which are used 

 so generally at times promiscuously by clinicians. A number of inter- 

 esting studies of this sort, however, are to be found in the recent literature. 

 One of the earliest is that of Federoff, in 1899, who concluded that the 

 most important effect was a slowing of the heart beat and an elevation of 

 the blood pressure. Concerning this last point there has been a great deal 

 of discussion. The most complete recent study has been by Gonalons. 

 This investigator insists that, in order to obtain accurate observations, 

 the solutions must be used within a very short time after preparation. He 

 finds that "immediately following the injection of 20 c.c. of maceration 

 or decoction of gravid corpus luteum, there is a rapid hypotension of 50, 

 60, or even 80 mm. of mercury. The pressure falls rather rapidly, cardiac 

 pulsations are generally considerably weakened, and there are sometimes 

 in the first moments deep convulsive respirations. After 1, 2 or 3 minutes 

 the pulsations strengthen and the pressure rises. This is relatively rapid 

 at first. After 5, 7 or 10 minutes, sometimes more, the pressure returns 

 to normal; at other times it persists a little diminished." The results 

 from a maceration or decoction of the ovary are somewhat similar, though 

 usually less marked than with gravid corpus luteum. Solutions of either 

 gravid ovary or gravid corpus luteum produce at first a lessening in the 

 amplitude of the heart beats, which is generally accompanied by a tachy- 



