Among the early warnings obtainable when large doses are being administered is 'undue loss of weight.
Loss of weight is an early sign of im provement, which sometimes goes beyond the requirements of health. Rise of tem perature and pulse, increase of urine, faintness, headache, prostration. cardiac weakness, and neuralgic pains have been observed during treatment. J. J. Put nam (Amer. Jour. Med. Sei., Aug., '93).
It is a powerful remedy, and must be used with caution. A daily dose or one every second day may be sufficient. One-half to 1 grain to children and 5 to 10 grains to adults personally given. J. H. Musser (Inter. Med. Mag., Nov., 1900).
When the preparation of thyroid first employed tends to give rise to untoward effects, a change of preparation is some times sufficient.
Case in which the glycerin extract of thyroid could not be taken, even in small doses, without, the production of very distressing symptoms, while the powdered extract was well borne. J. M. Anders News, June 12, '97).
If even then the preparations are not borne, portions of the gland or glandular extract may be administered by the rec tum. The extract, as shown by Lepine, can also be injected into the rectum.
According to Mackenzie, inunctions of a thyroidin ointment prepared as shown below may be employed.
When patients cannot bear even very small doses of thyroid, twice a day, after hot sponging and vigorous rubbing, the body is well anointed with the following mixture: 3 Thyroidin, 10 parts.
Ether, GO parts.
Lanolin, 4S0 parts.—M.
A rise of temperature of one degree followed the inunction. The process was well borne and followed by satisfactory results. E. Blake (Pros'. Med. Jour., Sept. 1, '94).
Arsenical preparations antagonize thy roidal intoxication through the energetic restraining influences of arsenic upon oxidation processes. They diminish the palpitation of the heart without in any way interfering NN ith the other good in fluences of the thyroid gland. Experi ments upon dogs and rabbits to which were administered thyroid gland and Fowler's solution and several cases showed that it was possible to push the thyroid gland in ascending doses more rapidly and with better effect when arsenic was given than without it. Ma
bille (Les Nouveaux Rein des, May S, '99).
Mabille's observation confirmed that arsenic obviates the unpleasant symptom excited by thyroid preparations. In 5 cases of idiopathic goitre, in a case of obesity, and 1 of infantile myxcedema, iodothyrin was given in progressive doses of from 3 'A to 30 or 38 '/, grains daily. At the same time arsenic was given, either in pills or as Fowler's solution, in doses increasing proportionately to the iodothyrin of V. to V,,, or even V„ grain daily. The results fully confirmed Ma bille's experience, for, though the 7 cases took respectively 231, 111, SG, 320, 108, 296, and 125 iodothyrin tabloids, con taining nearly 4 grains each, beyond oc casional increased frequency of the pulse no symptoms of thyroidism appeared, so that the course could be continued unin terruptedly. Arsenic, therefore, appears to suppress thyroidism with greater cer tainty than atropine does iodism, and it is now possible to give iodothyrin safely in doses and for a period capable of producing definite therapeutic effects. Ewald (Die Therapie der Gegenwart, Sept., '99, and Med.. Review, Dec., '99).
As noted in cases treated by Stabel, thyroid gland is likely to cause gastric disturbance most frequently during warm weather. He found that this could be avoided by preserving the glands or their preparations on ice, when they were not to be used at once.
According to Lanz, the danger con sists more in the extreme alterability of the products than in the toxicity of their active principles. A series of experi ments showed that 9 grains of the English thyroidin, dried by the ordinary procedures, gave rise to tachycardia, whereas the absorption of from 5 drachms to 1 ounce of raw fresh thy roid gland did not give rise to any disturbance. Examination of pastilles, tablets, tabloids, capsules, etc., revealed bacteria, including even the septic vib rio, ptomaines, etc.