ADDISON'S DISEASE.
At best only treatment of symptoms is indicated; very often the administration of Suprarenal Gland Extract produces no effect whatever upon the progress of this disease; nevertheless, since there is no other agent which exerts any specific action, it always should be given as a routine procedure, because undoubtedly, in a small percentage of cases, marked permanent benefit has been obtained. In the late stages of the affection it nearly always fails to raise the blood-pressure, but when the disease is recognised at an early stage better results may be expected. The dried extract may be given in I-gr. tablets, each of which corresponds to 15 grs. of the fresh gland; 4 of these may be given in the 24 hours. The writer believes that the drug should be commenced in smaller doses at shorter intervals—i.e., half a tablet every 2 or 3 hours, and the dose increased steadily till up to 2 } grs. of the dried substance be taken every 3 hours. Hypodermic injection of Adrenalin (2 mgrms.) may be resorted to when the gastric irritability is very prominent, or r dr. of the raw or partially cooked medullary portion of the sheep's gland may be ad ministered, as its efficacy is but slightly diminished by the action of the gastric juice; it is readily absorbed by the rectal mucous membrane.
Tyramine o•o5 may be injected in desperate conditions caused by low blood-pressure.
Much may be achieved by symptomatic treatment in other directions, and the life of the patient may be prolonged by complete rest in the hori zontal position, and the use of Bismuth combined with small doses of Morphia or Hydrocyanic Acid, or r min. capsules of Creosote to check the exhausting vomiting which is usually a prominent feature in the later stages of the disease. The profound amemia is sometimes relieved by Cacodylate of Sodium given per rectum, and the tendency to syncope is lessened by small hypodermic doses of Strychnine or Digitalin. The best article of diet at this stage is buttermilk diluted with an equal quantity of effervescing kali water in small and frequently repeated amounts. Constipation is best combated by enemata of tepid water. Open-air treatment, when practicable, is beneficial in all cases.