EXOPIITIIALMIC GOITBE. — In exoph thalmic goitre improvement is reported to have been obtained in about one half of the cases treated, but there is a striking lack of concordance between the various reports, some authors reporting series of cases in which all cases were materially benefited, others reporting failures on all sides. In a recent paper Hector Mackenzie described a series of experiments having for their object to determine the actual status of the ques tion. He compared results obtained in 15 cases in which thymus was used by other physicians to 20 cases under his own charge. In the 15 cases from other sources there was marked general im provement in no less than 14; in 7 the pulse-rate was markedly diminished; in 3 there was complete and in 4 partial disappearance of exophthalmos. Of the 20 personal eases, 1 died; in 6 there was no improvement; in 13 slight im provement. As to the pulse-rate, in 12 there was no change; in 2 it was in creased; in 5 it was slightly and in 1 markedly diminished; but in this 1 the improvement was merely transitory. Of 20 other cases in which remedies other than thymus were employed, in 11 there was no change, in 2 slight increase, in 4 markedly and in 3 slightly dimin ished pulse-rate; so that, from the side of the heart, there was no special bene fit from the thymus. As to the goitre, in 3 eases there was material diminution in size, and in 3 enlargement from thy mus. Of the 20 contrast cases: in 13 there was no change, in 4 cases more or less diminution, in 1 complete disap pearance, and in 1 enlargement. The balance, therefore, is against the thymus treatment. As to the exophthalmos, diminution occurred in only 1 case, and this commenced before thymus was tried. In the 20 contrast cases, 3 lost the ex ophthalmos. In the matter of general nutrition there was a slight weight in favor of the cases under treatment by thymus. Williams reported a case in which the symptoms were perceptibly aggravated and Kinnicutt, in two test cases carefully watched, could observe no improvement.
Case treated by raw sheep's thymus in doses of drachms to 7 drachms in gradually increasing doses about three times weekly. The subjective symptoms —the exophthalmos and tachycardia— were all diminished, but the goitre and tremor remained unchanged. Mikuliez (Berliner klin. Woch., Apr. 22, '95).
Case treated with capsules of dried thyroid, continued nearly two months without any perceptible influence upon her condition or upon the secretions, urea and uric acid being quantitively exam ined. After trying potassium bromide, nuclein, and an extract of spleen without favorable result, the patient, on July 15th, began to take capsules of dried aqueo-glycerin extract of the thymus gland, 3 a day, each of which contained grains. On August 5th feeling much better, although there were no obvious changes in the symptoms; on September 7th she was discharged re lieved. After having stopped the use of the thymus, in about four weeks after leaving the hospital, she was again pro vided with capsules to take twice a day On December Gth the pulse was 92. Im provement; swelling of the thyroid less, and patient able to work. R. T. Edes (Boston Med. and Surg. Jour., Jan. 23, '96).
Case of exophthalinic goitre which, in spite of all treatment, became steadily worse. Thymus-gland medication was begun and continued with the best re sults. The patient felt so well that, the supply of tabloids being finished, she stopped the treatment, and in a few weeks the exophthalmos was back again to a considerable extent. The tabloids were resumed, and in a short time their benefit was noticeable. N. J. McKie (Brit. Med. Jour., Mar. 14, '96).
Four cases treated by thymus. It cer tainly does improve the deranged heart action, but it seems more particularly to lessen the gastrointestinal symptoms and the tremor and general muscular weakness. Three of the cases had pre sented great psychical alteration; in all of them the mental state has improved readily. A. Maude (Lancet, July IS, '96).