602 CHEMICAL PATHOLOGY OF THE DUCTLESS GLAXDS 



the oro-an. ConsequtMitly wo find evidences of a decreased protein 

 metabolism, the urine containing a diminished quantity of nitrogen, 

 especially in the form of urea, while ammonia and other forms of 

 nitrogen are relatively excessive. A retention of nitrogen and phos- 

 phorus has been found, but not of calcium and chlorine."^ The 

 temperature is usually subnormal, and the energy metabolism is low.*'^'^ 

 Basal metabolism is lower than in any other known condition (Du 

 Bois).*'^'^ Fat and carbohydrate metabolism seem not to be propor- 

 tionately affected,"^ and hence the elimination of COj is relatively high 

 as compared to the nitrogen elimination. Gastro-intestinal disturb- 

 ances are common, with resulting increase in the amount of indican 

 and ethereal sulphates in the urine. Whether from this cause or 

 from deep-seated metabolic anomalies, there is a decided anemia, and 

 the ability of the corpuscles to combine with oxygen seems to be 

 decreased, so that the arterial blood may contain less oxygen than 

 normal venous blood. It is impossible to say whether the failure of 

 growth and development of the young (cretinism), and the mental 

 and physical torpidity of the adult, are due to an autointoxication from 

 products of intermediary metabolism which accumulate because of the 

 failure of the thyroid to furnish the "stimulus" necessary for their 

 complete destruction, or to a lack of some essential action of the thy- 

 roid secretion upon the nervous tissues and the growing cells them- 

 selves. Administration of thyroid extract to cretinoid children causes 

 retention of nitrogen and pliosphorus, but more strikingly of cal- 

 cium,*''' and obese cretins lose weight, chiefly from the non-nitrogenous 

 elements (Scholz). The amount of iodin in human cretin thyroids 

 seems not to have been estimated, but in five cretin dogs ^Marine and 

 Lenhart could find no thyroid iodin at all. 



The myxedematous change in the connective tissues is in the nature 

 of a reversion to the fetal type of tissue, and suggests that the thyroid 

 secretion is necessary for proper cell growth. This effect might be 

 either specific, or depend simply on the effect on protein metabolism. 

 Horsley'^" describes the appearance of the tissues of animals dying 

 after thyroidectomy as follows : ' ' The subcutaneous connective tissue 

 is swollen, jelly-like, bright and shining, and excessively stickA'. The 

 same thing is observed in the loose tissue of the mediastinum, about 

 the heart, and in the omentum. The submaxillary and parotid glands 

 are greatly enlarged, and have a semi-translucent, swollen appear- 



"S Benjamin and Rpuss, Jalirl). f. Kinderlicilk., lOOS (67), 201. Tn a cretin 

 Greenwaid found littlo deviation from normal. (Areli. Tnt. ^Vfed., 1!)14 (14), 

 374.) 



03aTalhot, Aiiier. .rour. Dis. Ciiil., inUi (12), 1-1."). 



«3bArch. Int. Med., lOlO ( 17) , nif). 



^14 Rarely myxedema and diabetes have been observed cuiijoiiith' (see Strasser, 

 Jour. Amer. ^ie<l. Aasoe., 1006 (44), 7f).'i). 



<i.-. See Iloiipardy and Lancstein. Zeit. f. Kiiiderlieilk.. inO.'. (til), fi;?.'?. Full 

 fipures are {riven bv Seliolz, Zeit. exp. Palli. u. Tlier,, Iddd (2), 270. 



""Brit. Med. Jo'ur., 188.5 (i), 211. 



