442 INANITION AND MALNUTRITION 



(B) Effects of Partial Inanition 



The effects of partial inanition upon the thyroid gland have been noted in 

 protein deficiency (malnutritional edema and pellagra), salt (especially iodin) 

 deficiencies, deficiency of vitamins (B and C) and aqueous inanition (thirst). 



Protein Deficiencies. — In human malnutritional edema, Paltauf ('17) found 

 the thyroid gland usually diminished in size, weight 10-15 g-; rarely larger. 

 Oberndorfer ('18) likewise found the thyroid gland extremely small, sometimes 

 not exceeding 12 g. in weight. Histologically the follicles were atrophic, 

 with thickened colloid and indications of hyposecretion. Lubarsch ('21) 

 mentioned hemosiderin deposits in the epithelium of the thyroid and other 

 glands. Tallquist ('22) found the thyroid usually much decreased (sometimes 

 to 3^) in size and ascribed the effects of malnutrition in famine edema and 

 similar disorders largely to endocrine (especially thyroid and suprarenal) 

 insufficiency. Curschmann ('22, '22a) likewise emphasized the atrophy of 

 the thyroid gland as a factor in malnutritional edema. 



In young rats fed on a diet with maize (tryptophan-deficient) replacing the 

 casein, Cramer ('23) found marked histological changes in the thyroid gland, 

 with cutaneous myxedema, indicating hypothyroidism. He noted that, accord- 

 ing to Kendall, the active principle of the thyroid gland, thyroxin, is an iodin 

 derivative of tryptophan. 



In pellagra (considered primarily due to protein deficiency), Agostini ('02) 

 ascribed the occurrence of infantile myxedema and arrested development to 

 thyroid lesions from maize toxins. Valtorta ('12) noted the frequency of goiter 

 and cretinism in pellagrous countries and described the changes in the thyroid 

 gland. Rossi ('13) found no histological changes in the thyroid gland, but 

 according to Raubitschek ('15), Agostini found typical atrophy of the thyroid, 

 which was even considered as the cause of pellagra. Morse ('16) in one case 

 also described lesions resembling "chronic productive interstitial thyroiditis 

 with compensatory reaction on the part of the thyroid follicles." There was 

 marked fibrosis with small areas of round cell infiltration, and islands of degen- 

 erating thyroid follicles. 



Sclerosis and other lesions of the thyroid gland were observed by Rondoni 

 ('15, '22) in guinea pigs on maize-diet, which, however, is known to be deficient 

 not only in protein, but also in various salts, vitamins, etc. Likewise uncertain 

 as to causation are the hyperemia and hyperplasia of the thyroid described by 

 Watson ('10) and Tanberg ('10) in rats on a meat diet. Mellanby and Mel- 

 lanby ('21) also found that in puppies the thyroid glands were small and normal 

 in structure when cod liver oil was the only fat in the diet, but showed more or 

 less hyperplasia on other fats, especially on butter (which caused five-fold 

 increase in weight). It is possible that these changes may depend upon dietary 

 differences in mineral or vitamin content, as well as in fats. 



Murray ('23) found in puppies with rickets produced by unhygienic 

 environment hyperplastic changes in the thyroid gland, similar to those seen in 

 some infections. These changes were not found in the rachitic-like disorder 



