One very important function of the thyroid is to stimulate brain-metabolism. We must regard the thyroid extract as containing a most potent cerebral stim ulant which does alter, in some way, the metabolism of the nerve-centres and stimulates them in a most extraordinary manner. William Osler (Jour. of Nerv. and Mental Dis., Apr., '96).
Forty cases, consisting chiefly of com mencing senile dementia, acute mania, and melancholia, treated with thyroid. Of these, eight were unaffected by the treatment, twelve were somewhat and fourteen were much improved, five cured, and one died. The drug had an alto gether extraordinary influence on the mental condition of the patients. Among clinical symptoms during the use of the remedy, rise of temperature and pulse rate, gastric disturbances, increased per spiration and quantity of urine, transient albuminuria in 10 per cent., cudema of face and extremities, cyanosis, desquama tion of the skin, sexual excitement,—so that masturbation in three cases necessi tated the discontinuance of the thyroid extraet,—were observed. C. G. Hill (Trans. Med. and Chir. Fac., Maryland, p. 30, '96).
Thyroid treatment of great value in a form of mental disturbance occurring at the climacteric: a mental depression with anxiety and morbid fears, but with out delusions of insomnia. Allen Starr (Amer. Jour. Med. Sci., vol. cxiv, No. 1, '97).
Insane cases in which a pill containing 5 grains of fresh sheep's gland was ad ministered daily, and subsequently in creased to two or three according to re sults. Besides the usual symptoms there was more or less mental or motor excite ment in all eases no matter how de pressed or demented the patients had been previous to the administration. In some instances there was considerable mental improvement. Berkley (Johns Hopkins Hos. Bull., July. '97).
In conditions marked by inhibition of sensory, motor, and mental activity, without gross organic lesion, such as obtain in catatonia and in certain types of stuporous insanity and melancholia, we may expect benefit from thyroid med ication, judiciously used.
Results of thyroid feeding in twenty patients. The extract, in tabloids of 5 grains each, administered. 1. Melan cholia agitata. Four females and one male. The four females were unim proved, the male greatly benefited. 2. Melancholia. Three females and four males. The females and all but one of the males were unimproved. 3. Senile dementia. One female. No improvement under treatment. 4. Chronic mania. Two females. No improvement under treatment. 5. Mental enfeeblement. One
female and two males. No improvement under treatment. 6. Dementia. One female and one male. No improvement under treatment. In all cases the pulse was the first to show any change, and was most affected by the drug. Robert Cross (Edinburgh Med. jour., Nov., '97).
Results of administration of thyroid extract on the red and white corpuscles and hcemoglobin in cases of amemia as sociated with melancholia. In 9 cases thyroid medication was employed and in 5 cases there was a marked change for the better; in the other no favorable in fluence was noted. In 3 of the 5 in which improvement took place there was increase of weight during the treatment, and in 2 subsequently. The psycholog ical effect was observed almost from the beginning in those in which permanent improvement took place. Samuel Bell (Phila. Med. Jou•.; Brit. Med. Jour., July 9, '98).
As a result of thyroid treatment in 1032 collected cases of insanity, the fol lowing conclusions reached: 1. The dose of the extract depends entirely on the individual ease. In some cases 25 grains three times a day will be necessary to bring about a circulatory or temperature reaction, while in others the same results may be had with the use of 5 grains d. Each case must be a law unto itself. 2. It is essential that the patient should be placed in bed to obtain the best results, and he should be continued there during the entire treatment and for a week following its discontinuance. 3. The treatment should be continued for at least thirty days. 4. We should not be discouraged by failure in the first ad ministration, but should resort to two, three, or more trials, if necessary. 5. The most gratifying results in thyroid treatment are to be obtained in cases of acute mania and melancholia with pro longed attacks, puerperal and climacteric insanities, stuporous states and primary dementia, particularly where these forms of mental alienation do not respond to the usual methods of treatment. 6. A high temperature reaction is not essen tial, as the average maximum tempera ture in the recovered cases among men was 99.6°. 7. Physical improvement is the outcome in most cases whether men tal improvement takes place or not. 8. The proportion of individuals who re cover under thyroid treatment and then relapse is less than the proportion that relapse after recovery from other meth ods of treatment. In personal series of cases only one patient who recovered has relapsed. William Mabon and Warren L. Babcock (Amer: Jour. of Insanity, Oct., '99).