ARRESTED GROWTH. — In the treat ment of dwarfing thyroid extract has been found to he of great value, whether the condition be associated with idiocy or not. The observations of Virchow, in 1883—to the effect that rachitis, cretin ism, and dwarfing were dependent upon disease of the thyroid gland, fully sup ported by experiments showing that thy roid feeding was capable of restoring normal growth when the latter had been arrested by thyroidectomy—pointed dis tinctly to thyroid as a valuable remedial agent. More recent experiments have further sustained this view and shown that the leanness attending rapid growth in youths could be attributed to an ex aggerated activity of the thyroid gland.
Effort of thyroid in children and youths who, although not cretins. were backward in growth. In 6 of these cases, in which the arrest of growth was due either to chronic a Ibuminuria (2). rickets (2). masturbation (11. or congenital de bility (1 i. there was a renewal of active growth.—in some very considerable. E. Herthghe Bull. de l'Acad. Royale de Mclul. de Belgique. '951.
In three eases of myxcedematous idiots, aged from 14 to 30 years, the striking points were growth and a loss of weight. In three other cases of obesity in idiots the growth under treatment was pro portionately more in four, five, or six months than the average growth of the eighteen untreated imbeciles or epileptics during their tenth, eleventh, and twelfth years, which were taken as more nearly approaching normal children to control these experiments. Bourneville (Progres MM., Feb. I, '96).
The rate and amount of the increase in height is in inverse ratio to the age of the patient and to the stage of the treatment. Thus, children grow more than adolescents, and adolescents more than adults; the rate of growth is at first very rapid, but becomes slower as the height approaches that of the nor mal for the age. John Thomson (Brit. Med. Jour., ii, 615, '96).
Number of recorded examples of dwarf ing associated with atrophy of the thy roid gland cited. Experiments on ani
mals corroborate the idea of a direct connection between the two conditions. Four cases in which thyroid treatment was resorted to to overcome dwarfing in children, in which normal height was reached. J. J. Schmidt (Therap. Poch., Nov. 15, '96).
In nine cases, including four idiots, large doses of sheep's thyroid (half a lobe every day or every second day) given. The way most of them gained in height was most remarkable. In one the gain amounted to 2 V, inches in five months. Boullenger (Pediatrics, Mar. 15, '97).
Case of cretinism in which patient was 30 years of age, and resembled a child of 7 or 8 years as to height. Under thyroid extract improvement was marked, in years the increase in height being 7 centimetres. W. Sinkler (Phila. Med. Jour., May 7, '98).
CRETINISM.—Clinical and experimen tal evidence have demonstrated that ab sence or impotence of the thyroid gland, as a result of insufficient development, removal, or neoplastic overgrowth, leads to a general condition at least closely allied to that witnessed in cretinism, while symptoms of myxcedema are pre eminent in the majority of cases. That much was expected from thyroid as a remedial agent need hardly be empha sized.
It may be s.aid that the hopes enter tained have been fully realized. The mental condition is greatly improved and the stunted growth is counteracted. As the patient approaches the height normal to his age the growth continues at the normal ratio. The myxcedema tons symptoms arc rapidly removed, the abnormal appearance being this in great part corrected. If begun early in the disease and continued systematically, the treatment seems capable of finally re storing the patient to a comparatively normal condition.
In a recent paper Osler was able to collect sixty cases of sporadic cretinism which had been observed in America, demonstrating that the disease is not limited to European countries, as thought by many.