606 CIIKMJCAJ, PATflOLOaV OF THE DVCTLEfi^ GLAyOS 



varies directly with the proijortioii of iodin, and such glands take up 

 iodin administered tlierajjeutically just as a normal thyroid does 

 (Koeher,**- i\Iarine and Leiiliart).^'^ These results, therefore, indicate 

 n()thiii<>- either for or a<i'ainst the liypothesis that exophtlialmie <>-oiter 

 is due to autointoxication with the secretion of the thyroid, but Wilson 

 and Kendall ^^^ find that in the toxic type of goiters there is but 

 Vio-Vi r. as much of the active iodin compound of Kendall as in normal 

 glands, and hence they suggest that in thyroid intoxication this toxic 

 material has been discharged from the thyroid into the circulation. 



On the other hand, it is impossible to produce a symptom-complex 

 resembling exophthalmic goiter ®*^ in animals by excessive feeding of 

 thyroid,^* either normal or from exophthalmic goiter; and after ex- 

 tensive study of the subject Marine and Lenhart have come to the con- 

 clusion that "the essential physiological disturbance of the thyroid in 

 exophthalmic goiter is insufficiency, its reaction compensatory and its 

 significance symptomatic." This view, however, certainly fails to 

 agree with the excellent results which come from partial extirpation 

 of the thyroid in exophthalmic goiter. Oswald,-^ also an experienced 

 investigator in this field, invokes an abnormally irritable nervous 

 system, which stimulates the thyroid and in turn is stimulated by 

 the thyroid secretion, constituting a vicious circle. Other observers 

 are of the opinion that not an excessive, but a perverted, secretion is at 

 fault,^** a view not confirmed by tests of the effects of thyroid extracts 

 on animals.^^ However, it is stated by Blackford and Sanford,*^ that 

 extracts of the thyroid in this disease, as well as the blood of patients 

 in the acute toxic stages, exhibit a marked depressor effect on blood 

 pressure, which is distinct from that of choline, and which they believe 

 to be specific for exophthalmic goiter. 



There can be no doubt that the thyroid secretion is capable of caus- 

 ing serious intoxication, for patients who have overused thyroid prep- 

 arations in the treatment of obesity, skin diseases, etc., have often suf- 

 fered severely from the symptoms mentioned previously, and, in at 

 least one such case, a diagnosis of exophthalmic goiter was made be- 

 fore the cause of the disturbance was detected. Not infre(|uently 

 evidences of acute intoxication have followed immediately after opera- 

 tions upon the thyroid, and these have been considered as due to 

 intoxication with the large quantities of thyroid secretion that have 



R2Arcli. klin. Cliir.. 1010 (1)2). 442; 1!)11 (90), 403. 



83Arfli. Int. Mi'd., 1!»11 (S), 205. 



!^3a Anier. Jour. Mod. Sci., 1010 (151), 70. 



'<4aT]if> patlio<roni'sis of tlie exoplitlialmos is iiiikiiowii. Seo Trocll, .Vicli. Int. 

 Mod., 1016 (17), 382. 



«t See Carlson et al., Anwr. .lour. I'lnsioi., 1012 CM)). 120; Marino, .lour. Anicr. 

 Med. Assoc, 1012 (50), 325. 



t*"' Correspdiidcnzlilatt Scliweizor Aerzto, 1012 (42). 1130. 



»"Klose rt al., Hcitr. z. klin. Cliir.. 1012 (77), 001. 



><" See Sclir.nltorn, Arch. exp. I'atli. u. riiarni.. 1000 i(;o), 300. 



f'WJour. Anier. Med. Assoc., 1014 (02), 117. 



