878 



JOHN R. WILLIAMS 



symptoms begin to return and the treatment must be repeated if further 

 relief is to be had. 



The daily iise of the hypodermic syringe as a means of medication is 

 not without obvious difficulties and dangers. In hospital practice, the 

 method is simple, but in the home it may be necessary to instruct a member 

 of the family of the patient in the technique of the procedure. 



To be helpful, the treatment must be .repeated daily and indefinitely. 

 The effects of long continued use of pituitrin are unknown. Williams' 

 case was given daily injections for more than a year and then at intervals 

 of a few days for several more months. At the end of that time, the 

 sensation of severe thirst had disappeared and the amount of urine voided 

 daily had decreased one half. The patient, without further treatment, 

 has remained free from thirst for more than one year, but exhibits to a 

 lesser degree the other signs and symptoms which were formerly present, 

 as weakness, eye disturbance, and headache. 



The administration of the commercial extract by mouth is without 

 value. Motzfeldt obtained fresh glands daily from an abattoir and fed 

 one patient intermittently from two to seven of these at night with 

 apparent, benefit. After two years' treatment, one fresh gland had the 

 same effect as seven formerly did. 



Christie and Stewart studied experimentally the action of pituitrin in 

 diabetes insipidus. It is their conclusion that the conductivity of the 

 blood serum is slightly increased and the relative volume of the serum 

 slightly diminished when water excretion is lessened by the extract or by 

 restriction of fluid intake. Blood flow in the hands seems to be increased 

 during the antidiuretic action of the extract, supporting the view that a 

 vascular effect in the opposite direction on the renal vessels may be respon- 

 sible for diminution in the urine secretion. 



Williams studied the clinical effect of pituitrin administration on 



