Biedl says: “A special pathogenetic significance is ascribed to thyroid insuffiency in the changes which occur in later life, and which are included in the term ‘cachexia of old age,’ or senile degeneration. The foundation for the theory that old age results from the changes in the thyroid gland lies in the fact that in old age the thyroid becomes atrophied, its follicles shrink, and retrogressive changes take place in the epithelial cells. This is reinforced by the fact that there is a profound analogy between the signs of advanced old age and myxœdema. The falling of the hair and the dropping out of the teeth, the dry and wrinkled skin, the lowered temperature, the diminished perspiration, the indolent digestion and consequent emaciation, the decrease of mental power and the diminution of the activity of the entire nervous system--these are all symptoms that characterize chronic myxœdema.” From the old partially true adage, that a man is as old as his arteries, we must go a step further back and say that a man is as old as his thyroid. This statement is probably not a final one, but it gives us a very valuable pointer in the way of treatment. Arterio-sclerosis and arterial degeneration are the almost universal accompaniments of thyroid deficiency, and are in most cases the result of that condition. There is no main or royal road to the successful management of sclerosis; every little cause must be thought out and righted if possible, but as a foundation nothing is so important, I think, as a clean, healthy intestine, which hitherto has been much neglected. A microscopical examination of the fæces will often show what is wrong, and also the direction and results of treatment. If the condition is thoroughly bad I begin with this rather drastic regime--twenty-four hours’ absolute starvation in bed, a tenth of a grain of calomel every hour for twelve hours and as much hot water as the patient can comfortably drink. This has a wonderful effect, and one’s subjective feelings after it tell us that evil has gone out of us and that good has taken its place. The treatment by bowel antiseptics has been generally very unsatisfactory. Beta naphthol helps, perhaps, but the most good comes from duodenal extract in some form. Two grains of the dried powder about two hours after each meal in pill or tablet act well. Carnrick’s Secretogen tablets and the much-advertized Jubol are good, and both depend on some extract from the duodenal mucosa. The unpleasant flatulence and the fermentation in the bowel soon disappear, and with them the mucus that is often shed from the coats of the colon. Better assimilation of food goes hand-in-hand with improved health and vigour. Intestinal dyspepsia is more far-reaching in its effects than gastric dyspepsia, but is often ignored.