298 STUDIES IN ADVANCED PHYSIOLOGY. 



right, is a soft dark purplish organ called the spleen. Its 

 dark purplish color at once enables the observer to distin- 

 guish it from the pancreas, which is light colored. Popu- 

 ularly the spleen is referred to as the "melt." ' It has no 

 ducts leading from it all. It is supplied from the aorta 

 with a rather large splenic artery and connected with the 

 vena cava with a large splenic vein. It is covered over with 

 peritoneum, but in addition to this has a connective tissue 

 capsule of its own. This capsule is largely fibrous, but con- 

 tains also bands of plain muscular fibres, to the presence of 

 which the contractions and dilatations which this organ un- 

 dergoes may be referred. From this fibrous capsule trabec- 

 ulse extend in through the gland and form a fine network 

 throughout its interior. This network is, of course, almost 



appeared thyroidism and the remedy was stopped for a few days and then resumed 

 under a decreased dosage of ten grains a day, slowly increased in the course of time. By 

 November he was able to sit up in bed and made attempts to use his extremities ; the 

 mental condition was fair. He continued to improve rapidly, and by the middle of Janu- 

 ary, 1897, he was able to rise and put on his coat; he even attempted to write a letter. 

 During March thyroids were discontinued; the daily dose at that time was twenty-five 

 grains. The patient at this time was able to use his legs to some extent, and by the mid- 

 dle of the summer he was able to walk about unassisted. This recovery was truly re- 

 markable. He has not had any further thyroid medication since March. Unfortunately, 

 mental improvement did not keep pace with the bodily. The patient had been a mild 

 maniac years ago, and symptoms of this would crop out now and then; he is, therefore, 

 still detained in the hospital. 



CASE) XVI. Age thirty-three ; recently passed the acute mania stage and became 

 chronic. At the beginning of the thyroid treatment he was quiet and well-behaved, al- 

 though delusional and wholly irrational. Under the influence of the gland he became more 

 active; marked symptoms of acute mania reappeared; the heart acted powerfully, and the 

 eyes bulged slightly. Such a reaction was, of course, not desired, and the remedy was 

 stopped, after having been given for several weeks. He soon relapsed to his former quiet 

 condition. 



Conclusions. My conclusions, based on my experience, may be briefly stated about 

 as follows: 



Under moderate continued doses of thyroid gland there is a marked bodily reaction 

 in many cases, but not in all. Some cases require comparatively large amounts before 

 any reaction occurs. There is a distinct stimulation of the nervous system, manifested 

 in various ways, and all bodily activities are increased. Tissue metabolism, especially of 

 the muscular and nervous systems, is markedly increased; a considerable loss in body 

 weight occurs in a short time; on suspending the remedy a rapid gain in weight usually 

 follows. In some cases there is a temporary lighting up of sensory or motor activities, 

 one or both, which soon disappear on discontinuing the remedy. Some cases of a certain 

 type (cataleptics) are benefited permanently; apparently all that is required for a restor- 

 ation to a life of normal activity is the stimulus derived from the substance of the gland. 



In moderate doses no ill results are produced. Under very large continued doses 

 a reaction occurs which is essentially an artificial attack of exopthalmic goitre, Any un- 

 favorable symptoms appearing under large dosage promptly disappear on withholding 

 the remedy. 



