In this direction we must realize the wonderful selective action of adrenalin, that of dilating the coronary arteries, contracting the arteries and arterioles of the skin and of the great splanchnic area and of dilating the deep arteries of the limbs. These selective actions explain the great relief it gives in asthma and acute respiratory distress, such as œdema of the lungs, where it bleeds a man into his own distal vessels. The absence of raised pressure in the brachial and radial arteries may be thus explained also. Again we must not forget that there may be, and probably is, something in the extract of the whole gland besides adrenalin. Administered by stomach the extract has, I think, far more effect than pure adrenalin given in the same way, and more lasting. Given by rectum, adrenalin acts quickly and powerfully. In France thyroid treatment is sometimes carried out by injections of an extract of the whole gland subcutaneously, but it is difficult to get an extract that is stable. In persons of middle age it is far more common to get the unpleasant heart effects of thyroid than in really old people, but it is not by any means an absolute rule. I know of two women well over ninety who cannot on this account take thyroid by itself for long. After sixty, thyroid in combination with pitglandin (the dried extract of the pars-anterior of the hypophysis) becomes very useful. At this time of life the internal secretion of the sexual glands begins to fail, and pitglandin, I think, compensates for their deficiency. When one thinks of the extraordinary influence that the pars-anterior has in youth on growth, and non-growth, causing gigantism and infantilism, one cannot be surprised at its having some powerful influence at the other end of life. It can be given in large doses, 1 or 2 grains, and seems to have no poisonous effects. Unlike pituitrin (pars-posterior), it does not raise blood pressure, but, I believe, has the opposite effect. The secretions of testis and ovary are probably mild pressure raisers, and as they enter into the formation of nearly all the pluri-glandular preparations that are on the market, this should be recognized. What may be of great value in neurasthenia, where the pressure is generally sub-normal, may be harmful in sclerosis. Most of these preparations contain also whole pituitary, and this again is harmful in plus pressure. It always strikes me as unscientific to give whole pituitary in any case, for the two parts are largely antagonistic in their action. The extracts of the sexual glands have been given, with the object of restoring sexual power (except for its side effects a thing of doubtful value), but if they prove to be pressure raisers, sclerosis will do better without them. In all probability pitglandin has a stimulating effect on the gonads, as it has on sexual development in childhood, but it does not raise pressure.