This case is offered to prove the absence of secretin and its effect when given by the mouth. As evidence of hepatic insufficiency the author apparently relies on the color of the stools, and for pancreatic insufficiency he cites the high urea output. He claims that when the pancreas does not furnish an efficient secretion, the proteins of the food fail to be converted into amino-acids, and instead, raise the percentage of urea. Consequently, he concludes that a high percentage of urea indicates the absence of secretin. It is usually held that a high percentage of urea depends on two factors, ingestion of a large amount of protein and concentration of the urine. The author gives no data as to the amount of albuminous food, the amount of urine, or whether the percentage of urea was learned by examining a single specimen or the total quantity for twenty-four hours. The mildest judgment that can be passed on such clinical data is that they are totally inadequate. Without doubt the percentage of urea could have been reduced to “normal” by causing the patient to drink water freely. The remaining cases show similar hasty conclusions from insufficient data, rendering them worthless as evidence. The G. W. Carnrick Company introduces a number of testimonials as to the value of Secretogen. These testimonials are similar to all testimonials. They include no evidence of careful diagnosis, and present an uncritical estimate of the results. They show that the writers have given Secretogen Elixir or Tablets indiscriminately in almost the whole range of digestive disorders, in nephritis, neuralgia, liver disease and gallstones, exophthalmic goiter, neurasthenia, epilepsy, etc. As dependable evidence, these testimonials are not worthy of consideration. A rational basis for the therapeutic value of Secretogen is lacking for the following reasons: 1. No evidence has been presented that the absence of secretin is a cause of gastro-intestinal diseases. It is usually present, and if not present, as in achylia gastrica, there is evidently some compensating arrangement by which the pancreas is stimulated to perform its regular functions. 2. There is no evidence that secretin in any form is physiologically active when administered by the mouth. REFERENCES Fleig, M. C.: Action de la sécrétine, Arch. gén. de méd., lxxx, 24. Charles, J. R.: Treatment of Diabetes with Secretin, Bristol Med.-Chir. Jour., September, 1906; Med. Press and Circular, Nov. 21, 1906. Meltzer, S. J.: Animal Experimentation in Relation to our Knowledge of Secretions, Especially in Internal Secretions, The Journal A. M. A., May 7, 1910, p. 1506. Wentworth, A. H.: The Cause of Infantile Atrophy, Deduced from A Study of Secretin in Normal and Atrophic Infants, The Journal A. M. A., July 20, 1907, p. 204. Bambridge and Beddard: Guy’s Hospital Reports, 1907, lxi, 161.