84 INTERNAL SECRETION 



found that the animals remained alive for a considerable time. 

 Later, by means of very exact experiments, v. Eiselsberg showed 

 that the implanted glands will heal into place and will remain 

 active. Prompted by the success which attended Schiff's experi- 

 ments, Kocher attempted thyroid transplantation with the human 

 subject, but with negative results; while Bircher (1890) obtained 

 a transitory relief of the symptoms by the same means in the 

 case of a woman with cachexia strumipriva. Horsley next pro- 

 posed the implantation of thyroid glands from sheep, not only 

 in post-operative myxcedema, but in true myxcedema and in 

 cretinism. The attempt was made by several surgeons and was 

 followed by favourable results, which lasted for a varying period 

 of time. Operative transplantation is, however, a comparatively 

 difficult and not altogether a harmless undertaking ; hence the 

 introduction of a method of substitution by means of thyroid 

 extract marked an important advance in technique. Moreover, the 

 results of this method have added considerably to our knowledge 

 of the functions exercised by the thyroid apparatus. 



In 1891 Vassale, who was soon followed by Gley, discovered 

 that the symptoms which follow thyroidectomy may be aborted by 

 the intravenous injection of the watery thyroid extracts. In those 

 days, the tetanic symptoms were believed to be the most important, 

 if not the only, signs of suppression, and it was just these 

 symptoms which were relieved by the treatment. Tetany and 

 cachexia were at that time still regarded as identical clinical 

 conditions. But we now know that the acute nervous derangement 

 which follows extirpation of the thyroid apparatus is due to the 

 removal, not of the thyroid, but of the parathyroids ; and it is 

 obvious that the results of the older substitution experiments, 

 whether by transplantation or by exhibition of thyroid extract, are 

 much in need of revision. 



The results obtained in tetany by transplantation of the 

 parathyroids and by the exhibition of thyroid extract have already 

 been fully discussed. It is proposed to quote here only those 

 results which have been obtained by the transplantation of the 

 thyroid gland itself. 



The experiments of Schiff and v. Eiselsberg were followed 

 by numerous others (Carle, Ribbert, Ferratti, Fano and Zanda, 

 Zuccaro, Bourchard, Lamari and Sgobdo, Cannizzaro, Ughetti, 

 Ferrari, Sultan, Pantaleone, Enderlen), and every method of 

 auto- and hetero-transplantation, with subjects of a great variety 

 of species, was attempted. The site of implantation was usually 

 the preperitoneal or subcutaneous tissue. Payr preferred the 

 spleen on account of the peculiarly favourable circulatory con- 

 ditions. Kocher proposed the cancellous tissue of the hollow 

 bones, bordering the epiphysial line the metaphyses of the tibia 

 as sites of implantation, and the results of such implantation 

 are described by Sermann. Salzer (1909) described the results of 

 peritoneal transplantation in rabbits. 



