During the last four years three-fifths of personal cases have been treated with iodine, and two-fifths with the thyroid preparation. In 30 thus treated it has been found that the patients who re ceived the iodine improved more rapidly than the others, and during the last three months all patients have been taking iodine, only accompanied by tonics as required. Few of them can take iodine steadily for many weeks without showing evidence of weakness; slight anaemia is likely to follow, with increased rapidity of the heart's action; often slight dyspncea and headache, with diminution of bodily weight. Therefore the patients should always be weighed when the treatment is commenced, and frequently afterward. The formula is as follows:— II lodini (crystals), 2 grains Pot. iodid., 4 grains. Alcoholis, 1 drachm. Syr. simplicis, 1 drachm. Aqum destil., 2 ounces.
A teaspoonful to be given in a wine glassful of water, one hour after each meal-time. After about two weeks, sometimes from the beginning, an iron tonic is given; Bland's pill, fern subcar bonate, or tincture of iron and, if the patients are weakening rapidly, strych nine combined with calisaya and iron, the iodine being discontinued for a week or two at a time. After three \ ;'eeks there is usually a perceptible difference in the size of the goitre. In six months
many of the goitres disappear, others are reduced from one-half to one-eighth their original size. Many patients breathe better and their voices improve. Some do not yield to the treatment. Three months' trial is sufficient in such cases. If the goitre is cystic, or if fibrois is extensive and the goitre interferes with the voice, respiration, or heart's action, or if there is a large goitre accompanying Graves's disease, and no contra-indica tion exists, operation should be advo cated. F. C. Schaefer (Jour. Amer. Med. Assoc., Nov. 25, '90).
The most promising cases for thyroid treatment are those of simple parenchy matous enlargement occurring in adoles cents and in young adults. The en largement is a true hypertrophy of the gland, which occurs in response to some demand for an increased supply of its secretion. With thyroid extract, the hypertrophied gland is able to pass into a resting condition. It is a useful pre liminary to operation, as it induces de crease of the gland, with relief of dyspncea. This is sometimes effected even in goitres in which cysts and ade nomata are present, by atrophy of the gland-substance in which the cysts or adenomata are imbedded. Murray (Edinburgh Med. Jour., Aug., 1900).