6. In some cases there appears to be developed a tolerance to the remedy whereby its effects are diminished in in tensity. For this reason it is better to begin with small doses and gradually in crease the amount given. W. A. New man Dorland (Ther. Gaz., Apr. 15, '99).
Preparations and Dose. — The ther apeutic uses of ovarian substance were studied by Touvenaint. Heifers' ovaries can be reduced to powder by desicca tion at a temperature of 25° C. Pills containing grains of the dry powder can be used, corresponding to 12 grains of fresh ovary. Three of these may he taken daily a quarter of an hour before meals. The average dose of dried ovary powder should not exceed 4 to 5 grains daily.
Liquid ovarian extract is another form: a glycerin extract of ovaries of young cows, containing 15 grains of ovarian tissue in 7 7„ minims of glycerin, which is injected into the buttocks daily in doses of 7 to 15 minims.
Compressed tabloids, containing 4 to 5 grains of dried gland, proved quite as efficacious as the injections, when two or three a day were given, and were finally used in place of the injections. The treatment can be continued for a month or more and is always well borne. (Muret.) Therapeutics. — In disturbances fol lowing removal of the ovaries or uterus, or in the nervous phenomena attending the menopause, ovarian tissue has given considerable relief. Lissae first tried crude ovarian tissue and ovarin by the mouth, and hypodermic injections of ovarian liquid; but ovarin was found to be most convenient, though it sometimes caused indigestion. The insomnia from which the patients all suffered was promptly relieved; cephalalgia generally disappeared and many psychical symp toms, mental depression especially, were ameliorated. In four of his cases uterine haemorrhages ceased under treatment. The treatment should be continuous, however, if the relief is to be maintained. Ile mentions sixteen cases treated by Jayle in the same manner in which the flushing was more or less relieved, but eturned after cessation of the treatment.
In exaggerated symptoms of the natu ral or induced menopause the ovarian treatment may be applied in two ways: (1) through transplantation of ovarian tissue. and (2) administration by the
mouth. In case of induced menopause through hysterectomy no effect was ob tained; but, of eases presenting severe symptoms during the natural menopause, three very much improved. Chrobak (Ccntralb. f. Gyn., No. 20, '95).
Tablets of 3 '/, grains (Merck) of the entire ovarian substances, of the precipi tate of the follicle-contents. or of cortical substance of the ovary of the cow, used in eleven patients, where either part or all of the internal genital organs had been removed; or where the patient complained of symptoms of the natura menopause: amenorrhoea, the result o atrophy of the genitalia, etc. The re sults were, as a rule, very encouraging the symptoms being very much relieved. Mond (Miinchener med. Woch., No. 14, '90).
Ovarian substance used in patients who had reached the climacteric age, who complained principally of sensations of fullness in the head, occurring many times during the day, pains in the back and legs, etc. The dose varied from 15 to 22 grains, administered in tablets con taining each 7 '1 grains of the ovaries of sows or cows. The sensations of full ness in the head had practically disap peared in two weeks. To avoid the in fluence of suggestion tablets containing none of the substance were given from time to time, but the symptoms immedi ately reappeared and the patients felt worse. The effect lasted only while the ovarian substance was being taken. Lan dau and Mainzer (Lancet, July 4, '96).
Ovarian extract tried in 21 cases, 9 nervous disorder due to menopause and of usual vasomotor origin, insomnia, lumbar pain, visceral troubles, flatulence, anorexia, etc. All cured or much im proved. Three cases of climacteric irreg ularity of menstruation: 2 were cured and I improved. Muret (Rev. Med. de la Suisse Rom., July 20, '96).
Ovarian extract appears to be par ticularly indicated in amenorrhoea and chlorannmia, in which the results are excellent. It is very useful in all cases of artificial menopause due to removal of the genital apparatus. It can also be tried with advantage for the removal of symptoms due to natural ine,nopause. Touvenaint (Med. Mod., Oct. 17, '96).