Gastric digestion, as shown by Howitz, in no way modifies the properties of the glands. Maurange has obtained a peptone which can be kept indefinitely either in the dry state or in a syrupy condition with the addition of an equal quantity of glycerin and alcohol. It may be given in wine or sweetmeats contain ing 50 per cent. of sugar. The author has used these peptones, named by him peptothyroidin, peptovarin, peptomedul lin, etc., for fifteen months and though still very imperfect and prepared only as needed, they have been perfectly tole rated even by confirmed dyspeptics.
As to the use of any of the active principles described, clinical results have not sufficiently sustained the theoretical views concerning their actual worth to warrant a wholesale recommendation of them. Again, physiological investiga tions have seemed to suggest that their influence upon general metabolism is dif ferent from that exercised by the com plete gland. Still, in a few instances, excellent results have been obtained from them and further study will doubtless make it possible to isolate an active prin ciple devoid of useless and perhaps harm ful elements. For the present, therefore, the gland itself or prepared in desiccated powder or capsule or in compressed tab let should only be employed.
A promising agent is Robert Hutch inson's colloid. Here, however, the in ert extractives removed are mere foreign bodies, the colloid itself being a compos ite protcid containing various active ele ments, including, probably, Baumann's thyroidin. We are not dealing, there fore, with an active principle per se, but, in reality. with the active part of the gland. The advantages claimed for col loid are: 1. A constancy of dose is in sured. The quantity of colloid in differ ent glands varies considerably; hence the amount of active substance in dried preparations of the whole gland is really not constant. 2. The drug is quite pure. 3. The pure colloid is free from taste and odor, and keeps indefinitely. 4. A very small dose is required. 5. The col loid is absorbed with great ease and ra pidity. 6. The administration of the col loid matter is really the most economical way of giving the thyroid. There is no waste of active material, as occurs in the preparations of thyroidin.
Therapeutics.—The diseases in which thyroid gland and its preparations are utilized are so numerous that a general review of the results obtained would af ford but little information. The various disorders, including the clinical data collated upon each, are therefore pre sented separately, and in alphabetical order.
The thyroid extract is a powerful al terative. Its use is likely to be of service, however, only in those diseases which are in some way related to par tial or total suspension of the thyroid function. Its action is almost specific in myxmdema, sporadic cretinism, and the cachexia which follows the extirpa tion of the thyroid gland. Its use in insanity is in some degree justified rationally on the ground that in that disease altered glandular action and disordered metabolism are almost uni versally found.
Thyroid is a constant ingredient in antifat remedies, and M. Purges has made extensive experimentation in this regard. He finds that the majority of cases show no improvement whatever, while the few, and those are those eases which readily show the physiolog ical action of the remedy, experience some benefit. He thinks that in these cases the fatness, in sonic measure at least, is due to the defective action of the thyroid gland, and hence the ex hibition of the thyroid extract is highly rational. On the whole, he condemns its use in this class of patients, as the benefits derived are not worth the haz ard undergone while taking the treat ment.
It has been tried in many forms of skin diseases, both internally and as a local application. The results reported are variable. Seleroderma, psoriasis, eczema, and ichthyosis are said to do well occasionally, and of late very en couraging reports of it have been noted in stubborn cases of diffuse eczema. Externally, it has been tried in various forms of chronic ulcer, but the reports of results have not been such as to show that it had any special value for this purpose. De Lace reports a case of severe purpura. in which thyroid effected a complete cure.
As an emmenagogue it has repeatedly succeeded when other means had failed, but, when given for this purpose solely, it seems to be useless. In cases of in sanity where the menstrual function was in abeyance, when the remedy ameliorated the patient's general mental and physical condition, return of the menses was among the other signs of improvement, but in no case was men struation re-established as the only apparent result of the treatment. In exophthalmic goitre, with or without mental symptoms, it seems to he posi tively harmful. Hiram Elliott (Brook lyn Med. Jour., April, 1901).