THE PROBLEMS OF THERAPEUTICS 181 



continued. When deficiency of the thyroid occurs in childhood, 

 the effect of treatment is still more manifest, for the child thus 

 affected becomes stunted both in body and mind, is dwarfish, feeble, 

 and idiotic. Under the administration of thyroid it grows rapidly 

 and becomes strong and intelligent and indeed develops into a per- 

 fectly normal person. The cure effected by thyroid in such cretins 

 is one of the most marvelous achievements of therapeutics and many 

 attempts have been made with portions of other organs or extracts 

 of them to supply material which is supposed to be absent in vari- 

 ous diseases. 



The first instance of this method of treatment, or opotherapy, as 

 it is called, was, I believe, my employment of raw meat thirty years 

 ago to supply the body with a ferment to use up sugar in diabetes. 1 

 The method was reintroduced by Brown-Sequard with more suc- 

 cess, but it was not until the use of thyroid gland and its extract 

 that the potentialities of the method became acknowledged. It 

 is more than eighteen hundred years since the question was asked 

 "Who can add a cubit to his stature?" and all this time we have 

 remained ignorant of any plan by which we could add a single inch 

 to a child's stature. Yet it now seems possible that by the use of 

 thyroid gland and pituitary body, children, who would be other- 

 wise stunted, may grow not only to the normal size but even above it. 



So long, however, as we do not know the chemical nature of the 

 substances which exercise such an extraordinary effect upon tissue 

 change we shall not be able to deal with them so satisfactorily as we 

 can now, in a way that was formerly impossible, regulate the tem- 

 perature in fever. The clinical thermometer not only shows us the 

 extent to which fever is present, but it enables us to stop the appli- 

 cation of our remedies in time so as not to reduce the temperature 

 to too great an extent. Cold water, ice, and diaphoretics were for- 

 merly the only antipyretic remedies, next salicin and quinine were 

 introduced, then salicylic acid was made synthetically, and be- 

 ing cheap was used extensively, and within the last thirty years 

 an increased knowledge of chemical methods and of the relation- 

 ship between chemical constitution and physiological action has 

 enabled numerous synthetic products to be formed, some of which 

 may be more useful in certain cases than the original salicylate 

 of soda. 



A great many of these substances primarily intended to reduce 

 the temperature have turned out to have a still more important 

 action, namely, the relief of pain. There is no doubt that pain is 

 useful as a warning against conditions which tend to destroy the 

 organism and leads us to shun or remove these conditions to the 

 great advantage of our health, but it is not always possible to do 



1 British Medical Journal, 1873. 



