Under thyroid treatment the goitre diminishes in size, and may even some times return to its normal condition. When the treatment is carefully carried out and the effect watched, no complica tions occur. It has also a beneficial in fluence upon the nervous system. K. P. Serapin (Wratch, No. 5, Feb., '96).
The fresh glands selected with care and preserved on ice do not give rise to the toxic symptoms so frequently re ported. In 25 eases of simple goitre of parenchymatous and fibrous character improvement was noted in 23, while in 2 the disease seemed completely arrested or cured. The treatment must, however, be continued to maintain the results ob tained. Tablets of thyroidin found con siderably less advantageous than the fresh glands. Stahel (Berl. klin. Woch., Feb. 3, '96).
Better results obtained with the tab lets than with the fresh gland, the most remarkable effects being observed in young chlorotic girls suffering from parenchymatous goitre. Complete re covery, however, did not take place, but slight symptoms of thyroidism, as moderate albuminuria with casts, noted, disappearing as soon as the treatment was suppressed. Ewald (Univ. Med. Jour., Apr., '96).
Use of tablets noted in three very care fully observed cases; the conclusions are as follow: 1. The goitre has diminished in size. 2. The body-weight is dimin ished, the most marked result being ob tained after long-continued use, and is in proportion to the amount of the gland substance taken. 3. The amount of urine is increased. 4. The nitrogenous excretion in the urine is increased. 5. The balance of nitrogenous excretion is a negative one: i.e., more is excreted than is taken in. 6. The uric-acid excretion is in creased, especially during the first days of the treatment. 7. The excretion of sodium chloride and of phosphoric acid is increased. Issai, B. Vas, and G. Gang (Deutsche med. Woch., No. 29, s. 439, '96).
No improvement obtained in ten eases in which tablets were tried. The treat ment was abandoned on account of the palpitation and emaciation which it caused. Mendel (Univ. Med. Jour., Apr., '96).
In the tetanic condition toxins are found in the blood which are rendered innocuous by the antitoxiu—"thyreo antitoxin" of Frankel—which is formed in the gland-alveoli. In the myxcedeina
tons condition, on the other hand, a poisonous proteid "thyroproteid" is formed in the tissues, passes into the blood, and is fixed by the thyroid. Here it is rendered innocuous by the action of an enzyme which splits it up into two parts: a proteid constituent which unites with "thyro-iodine," and the other a carbohydrate. Notkin (Virchow's Archly, Suppl., H., B. 144; Edinburgh Med. Jour., Mar., '97).
Iodothyrin used in four cases of goitre. The dose employed was 4 V, grains per day during extended periods, varying from one to three months.
In three of these cases, subjects from 12 to IS years of age, who presented small recent fleshy goitres, which were accompanied by intense respiratory symptoms, the medication caused a rapid disappearance of the dyspncea. After having been five months under treatment they are considered completely cured. Poucet (Revista de Laying., Otol., y Bin., No. 11, '97).
Case of goitre cured in a newborn infant by submitting its wet-nurse, who also had a goitre. to the thyroid treat ment. Every day during five days a tab let containing 22 grains of the gland was taken by the nurse; after an interval of five days the treatment was resumed, and so on until the treatment was dis continued. The infant's goitre disap peared after six weeks' treatment, that of the nurse became considerably smaller. Moose (Brit. Med. Jour., Apr. 23, '93).
Summary of results in S49 goitres, of which 33 were malignant. Thyroidin was found more efficient than iodine. Two hundred and thirty-six benign goitres were operated: 2 by puncture and iodine injection combined, 64 by enucleation, 174 by extirpation, and 1 by tracheotomy. Socin's method is now used in all cases.
The incision commonly used was a curved one along the border of the sterno-mastoid. Recovery, on an aver age, took 11 days after enucleation and 14 days after extirpation. The mor tality was 4 deaths from pneumonia, 1 by toxaemia, and 1 by chloroform death. In this case a persistent thymus was found. A. Schiller (Beitrfige zur klin. Chin, B. 24, H. 3, '99).