CUTANEOUS DISEASES.—The hopes at first entertained have been, to a great degree, dispelled by the results obtained. In psoriasis thyroid extract has not shown itself as effective as other forms of treat ment. In lupus and leprosy indications would seem to warrant further trial. The same might he said of keloid.
According to Don, who used thyroid gland with advantage in cases of ichthy osis, there is no doubt that it is strongly stimulating by directly increasing the cutaneous circulation, as evidenced in sensations of flushing, hot tingling, and congestive irritation, frequently felt as a precursor to ordinary perspiration. The increased cutaneous vascular supply ap parcntly results in: I. Increased nntri tion of the skin; hence its probable re medial action in ichthyotic conditions: an effect produced without any necessary abnormal perspiration. 2. Increased ac tion of the cutaneous glands, accelerating excretion of waste-products, thus keep ing the surface in a supple condition. 3. Regrowth of hair, as shown in myxce demo and some cases of general alopecia. 4. Increased activity of the epidermal layers, causing desquamation of un healthy epidermis and reproduction of a new covering, as observed in ichthyosis, psoriasis, dry chronic eczema, and also in some cases of myxcedema and cretinism.
In other diseases, however, in which the remedy was employed the results have been such as not to warrant fur ther trial. Indeed, the untoward effects sometimes attending its administration and the uncertainty of the results have caused many dermatologists to abandon its use altogether.
The use of thyroid extract is only per missible when the patient can be kept constantly under observation, because of the severe and sometimes dangerous symptoms which it produces. Zarubin (Archly f. Dermat. u. Syph., B. 37, H. 3. '96).
The thyroid extract has certainly no specific action in scleroderma, as it- has in myxcedema. In no case did the skin of the affected regions become softer or regain its natural appearance. In two eases the disease did not progress under its use. Two of the eases—one with
tachyeardia—took it for eighteen months. and another for nineteen months, with out any ill effects; the latter ease gained weight. W. Osler (Jour. of Cut. and Genito-Urin. Dis., Mar., '98).
Curative effects observed in urtiearia. The extract was being used for obesity with chronic and persistent constipa tion. The patient for several years had been a victim of urtiearia. She had been treated at various times with no results. Two hundred 5-grain tablets of the extract were taken at the rate of three per day. From the third day (eight months ago) she has not been troubled either with the constipation or the urtiearia, though the obesity was not influenced. J. N. Roussel (New Orleans Med. and Sing. Jour., April, 1902).
Psoriasis.—Of all the skin affections psoriasis is the only one in which thy roid extract seems to have proved bene ficial in a reasonable proportion of the cases in which it was used. But at best its effects arc not to be relied upon, and it should only be tried after arsenic and other standard measures have been fully tried.
Four eases of psoriasis treated by thy roid extract, in the form of pastilles. Two daily, equivalent to one thyroid gland, were given. One of the patients took thyroid gland daily. In none of the eases did any improvement result from the use of the medicament. The inges tion of a thyroid gland in one ease pro duced a febrile condition, nausea, and diarrhoea, without any manifestations of acute dermatitis. Menau (l'Eneephale. June 10, '94).
Results in twenty eases of psoriasis: In a very considerable proportion of cases the thyroid treatment produces a tempo rary cure, the eruption entirely disap pearing and the skin being left in all absolutely healthy condition. In excep tional cases small doses produce a rapid improvement, while. in others improve ment is only produced after distinct symptoms of thyroidism. Some obstinate cases ultimately yield to very large doses, continued for a long time.