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The evidence showed definitel}' that the internal secretion of the gonads caused Slimfast Shaker the appearance of the secondary sexual characteristics. The term originated with John Hunter. Those secondary changes were the changes occurring at puberty. Cer- tain experiments, especially those of Steinach, showed the great importance of the internal secre- tion of the testicles and ovaries. Steinach laid so Cheap Slimfast Products much importance on this interstitial tissue that he named it the puberty gland, indicating that puberty depended entirely upon its action. By experiments on animals he showed that these secondary sexual characteristics could be produced. Thus male rats October 30, 1920.] PROCEEDINCfS OF NATIONAL AND LOCAL SOCIETIES. 695 which had been castrated before puberty and in whom an ovary had been transplanted took Purchase Slimfast on sec- ondary female characteristics ; the same was true Order Slimfast Online of rats of the opposite sex. We did not know the stimulus that called into activity this property of the gonads. It might depend on the interactivity of other endocrine glands — for instance, the hypo- physis. Gonadal stimulating The Slimfast Diet properties might exist in all Buy Cheap Slimfast endocrine glands. We should find clinical cases in man sho.wing the results of hyperfunction or hypof unction of these organs; that is, we should find cases of precocious Slimfast Canada or delayed puberty in both sexes. We could also study the effects of double ovariotomy. Mild Types of Thyroid Toxic Adenomata. — Dr. Malcolm Slimfast Meals S. Woodbury, of Clifton Springs, said there were two varieties of goitre which might be toxic — the exophthalmic type and toxic adeno- mata. The opinion was that adenomata were em- bryological in origin, derived from fetal rests. Work was being Slimfast Cost Slimfast 123 Plan done on this and would be published soon. For Buy Slimfast Online the clinician it was im- portant to recognize th^t adenomata might appear as distinct nodules Slimfast Price or there might be a diffuse process, as shown by the microscope ; the absence of nodules did not rule out this condition. The recognition of thyroid adenomata as an entity marked an advance. They might attain a large size, but usually not without toxicity. The mild ones might produce only pressure symptoms. Small adenomata might be toxic just as small exophthalmic goitres might. Plummer stated that thirty-three per cent, of all hyperfunctioning thyroids were adenomata. It was obviously of the greatest im- portance to differentiate toxic states associated with goitre from psychoses. The term thyroto.xicosis was Purchase Slimfast Online better than the term hyperthyroidism when applied to adenomata. In our recent short series there was a family history in eighty per cent, of the cases and infections of the tonsils or teeth in ninety per cent. ; all the patients came from districts in which goitre was rather common. Probably the 'etiology was somewhat as follows : It appeared that fetal rests might be transmitted more com- monly in certain families ; be due to the water con- tent in localities requiring an overactivity of Slimfast Australia the thyroid in metabolism adjustment, to disturb- ance of the sympathetic nervous system, or to pregnancy. The cells proliferated and took on the form of adenomata. Whether the activity was due to cells in the adenoma per se or the surrounding cells was not Slimfast 123 yet established. Nervous symptoms in the cases of adenomata were no different from those in the exophthalmic cases. In adenomata fifty per cent, of tlie Slimfast Tablets patients complained of depres- sion which was dift'erent from the depression of psychoses in the Order Slimfast absence of self accusatory delu- sions. Definite Slimfast Snack Bars nodules could be felt in half the cases, although palpation must be done carefully to detect them. Dr. Woodbury described his method of palpating the thyroid to detect adenomata. With the patient sitting with the head on a head rest turned toward the side on which the examiner stood, the landmark to palpate was the oblique ridge on the als of the thyroid cartilage when the patient swallowed. The metabolism rate had received a great deal of attention since the portable apparatus of Bene- dict had come into use, but too much reliance must not be placed on it and it was necessary to allow for differences in weight, age and sex. An increase of not more than fifteen per cent, was to be considered normal. Adenomatous cases might show only a slight increase in basal metabolism or no increase at all, and the question arose whether these were cases in which a toxic element was playing a part. Dr. Woodbury thought they were. Slimfast Cheap The Goetsch test was positive. The patients were operated on by Dr. C. W. Webb, with good results where the

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