No case should be regarded as hopeless unless thyroidism has been produced, the largest dose which the patient can take having been continued for at least two months. In several eases the fir-A effect of the remedy is to produce an extension of the eruption, this being most marked in eases in which the treatment is most successful. In some eases the treatment produces no effect. Relapses are not prevented. Long-standing. chronic eases are more readily cured than the more recent ones. Treatment begun with small doses and increased until distinct symp toms of thyroidism are produced. Byrom Bramwell (Jour. of Dermatology, July, '94).
Disappointed with the effect of thy roid in psoriasis. Although some of the cases treated had been benefited in a marked manlier, the majority had not. Even in the cases that had been improved equally good results, with much less dis turbance of the patient's health, would have been achieved by the vigorous use of external remedies, such as ointments and baths. P. S. Abraham (Med. Press and Circular, Jan. 2, '9:5).
Thyroid treatment has a limited sphere of usefulness; unsuited for elderly patients with weak hearts. Radcliffe Crocker (Lancet, June S, '05).
Twenty-four cases of psoriasis, eleven of which were cured and seven were im proved by the treatment. In a few cases even tolerably large doses seemed to have hardly any effect. It does not seem at present possible to distinguish before hand those cases of psoriasis which are benefited by the treatment from those which derive no benefit. Z11111 Busch (Derm. Zeit., Sept., '05).
Cases successfully treated by thyroid extract. Wilson (Brit. Med. Jour., Feb. 16, '93) ; Preece (Brit. Med. Jour., Mar. 30, '05); see Annual, '96.
Thyroid extract used in psoriasis in six cases, in only one of which it was successful in curing the disease. H. S. Purdon (Dublin Jour. Med. Sciences, Nov. 2, '96).
Case of psoriasis with insanity. The patient was depressed, suspicious, and his memory was impaired. He was put to bed and thyroid tablets, in 15-grain doses three times a day, were admin istered. On the third day a marked change in the mental condition was ob served. IIe woke up from his confused lethargy, appeared quite collected, read a newspaper, and took an interest in his surroundings. His improvement was steady. The thyroid was reduced to 5 grains a day on the eighth day, and this amount was given daily for an other week. The psoriasis had entirely
disappeared by the end of the fourth week, leaving very little scarring. He had lost sixteen pounds in weight dur ing the treatment, but he soon regained his lost flesh. He was discharged cured two months after admission, and eight een months later had had no return of the skin or mental affection. II. de Maine Alexander (Lancet, Dec. 8, 1900).
lupus vulgaris thyroid has not been extensively tried, but the bene fit derived in a number of cases, and the unfavorable results attending other forms of treatment, warrant further investiga tions. Large doses are required.
Two cases in which thyroid extract was used: In the first, a girl aged 1G'/, years. whose disease had persisted for nine years. covering the nose, left cheek, and upper lip, and extending from each corner of the mouth to the chin. admin istration of the extract was continued, with a few intervals, during six months. At the latter date the improvement way marked. in an intermission the disease retrograded, but improved again on the resumption of the thyroid treatment. After a year the patient was much im proved, not cured. The second was a girl, aged 18 years, whose nose, mouth, and right eyelid were affected. Notice able improvement was made within a month. Byrom Bramwell (Brit. Med. Jour., Apr. 14, '94).
Case of lnpus vulgaris treated with thyroid extract and linear scarification. Face wonderfully improved. On passing the finger over the lupus it is found to be perfectly smooth and the ulceration apparently healed. G. G. Stopford Tay lor (lied. Press and Circular, Oct. 3, '94).
Cases in which treatment by thyroid extract proved beneficial, but not cura tive. Abraham (Brit. Jour. of Derm., Aug., '94) ; Lake (Jour. of Laryn., Feb., '05).
Four cases where the results had been extremely good. P. S. Abraham (Med. Press and Circular, Jan. 2, '95).
Thyroidin appears to cause local re action somewhat resembling that caused by tuberculin. Zuni Busch (Derm. Zeit., Sept., '95).
Duration of treatment necessary to insure permanent cure, even with full doses given regularly and continuously, not shorter than one year. The dose in lupus, as in psoriasis, requires to be larger than what is found sufficient for myxcederna. The older the patient, the more cautious ought we to be with the quantity prescribed. J. Barclay (Brit. Med. Jour., Oct. 24, '96).