UTERINE DISORDERS.—Certain condi tions influencing the genital apparatus —such as puberty, pregnancy, fibroid tumor, which cause a distinct change in the metabolism of the entire organism— very frequently cause an enlargement of the thyroid gland. Again, the deficiency of the normal thyroid secretion follow ing thyroidectomy in myxcedema, cre tinism, etc., is often associated with atrophic changes in the genital appa ratus, as shown by Fisher, of Vienna. This sufficiently indicates direct associa tion between the thyroid and the genital system to warrant careful investigation into the uses to which thyroid extract might be put in the treatment of diseases of the reproductive tract.
The deficiency of glandular substances in the economy experienced at the meno pause seems to suggest that there is some lost principle which we may thera peutically supply until the system has gradually become accustomed to effect the necessary metabolism independently. Quite recently it has been claimed that iodine salts are always present in thyroid extract, which may partly explain the effect. Leith Napier (Brit. Gyncec. Jour., Aug., '96).
The administration of thyroid extract as a palliative of uterine fibroids caused improvement, especially in cases that took the remedy longest. The mani festations were: (a) control of the menstrual flow; (b) arrest of the growth, and, in some cases, diminution in the size and apparently softening of the tumor; (e) disappearance of pain and diminution of tenderness in the growth, and also of the sense of abdom inal and pelvic distension, with increase in muscular and nervous energy; (d) betterment of the general nutrition, manifested at first by slight loss and then by return of flesh; improved state of the skin, hair, and nails, and in the substitution of a good color for the ap pearance of anaemia. The nearer the growth approaches the type of pure rnyoma as distinct from fibromyotna, the better the ultimate result. William M. Polk (Med. News, Jan. 14, '99).
1. The thyroid gland, in addition to its general effect upon the metabolism of the body, exerts an inhibitory action upon the pelvic genital organs, and upon the uterus in particular. This ac
tion seems to be especially marked upon the epithelial elements of the endo metrium. 2. As a result of this inhibi tory, or vasoconstrictor, action there fol lows a retardation of haemorrhages from the uterine mucosa. 3. This action is directly antagonistic to that exerted upon the uterus by the ovarian secretion. 4. In cases in which this conservative influence is deficient or absent it may be restored by the ingestion of fresh thyroid gland or desiccations or extracts of that organ. 5. In gynaecology thyroid therapy is especially indicated in luemorrhagic affections of the uterus and in all forms of pelvic congestion, notably in uterine fibromata, limmorrhagic endometritis, menopausal haemorrhages, and chronic tubal diseases. 6. The best results are to be expected in fibromata and patho logical conditions of recent development. The more chronic the ease, the more re bellious will it prove to thyroidization. 7. The thyroid influence is also found to cause an increase in the metabolism of the mammary gland, and the treatment is therefore indicated in all cases of in sufficient lactation. W. A. Newman (Ther. Gaz., July 15, '99).
So far, thyroid extract has furnished marked evidence of its value for the pur pose of arresting hemorrhage whether this occur in connection with abortion, the menopause, tumors, or uterine mal positions. A remarkable case of metror rhagia due to bwmophilia successfully treated with thyroid extract is reported by Dejace.
Thyroid extract an excellent remedy in threatened abortion with haemorrhage, and is valuable in preventing the arrest of uterine involution after childbirth. Ch6ron (Revue Medico-Chir. des Mal. des. Femmes, Nov. 25, Dec. 25, '90).
Thyroid extract is particularly favor able in cases of uterine haemorrhage. In purely functional cases the results had been a complete and lasting cure, also in the haemorrhages of menopause or de pendent on uterine malpositions. The growth of fibrous tumors is also checked by retrogression, and cure has followed its use early in the history of the cases. Jouin (GynOcologie. Oct.. '97).