DYSTHYROIDISM 121 



roidism suggests that it probably plays some role in 

 this disease. The power of the Roentgen rays to affect 

 thymus as well as thyroid hypertrophy, is a strong 

 point in favor of their use. (Holmes & Merrill 23 .) 



In addition to the probable involvement of chromaffin 

 and thymus tissue in dysthyroidism, as already men- 

 tioned, there is the well-known fact of anterior pitui- 

 tary hypertrophy following thyroidectomy, all of which 

 add support to the contention that it is not a disease 

 of the thyroid alone. Bertine 24 found that out of 134 

 cases of the thyroid disease at least 60, almost half, 

 presented features indicating disturbance in other en- 

 docrine glands. It becomes apparent that no endocrine 

 gland "exists unto itself alone." Nowhere in the realm 

 of medicine is there a better illustration of the dic- 

 tum, "There are no pigeonholes in nature," than in 

 diseases of the ductless glands. This complexity makes 

 their study and treatment a difficult problem, one which 

 internal medicine alone may solve because, in its appli- 

 cation, no gland or part thereof is removed from its 

 sphere of activity, no matter how abnormal its func- 

 tion may be at any given time. , 



Recapitulation: Dysthyroidism is a self-limited 

 disease in which perverted function is the dominant 

 feature and in which other endocrine glands play more 

 or less important roles. Rational therapy should aim 

 to carry the patient through the course of the disease 

 with as little suffering and permanent disability as 

 possible. Individualization is necessary in each case, 

 and this is only possible through careful clinical observ- 

 ation. Such intensive study of every case will progres- 

 sively unravel the mysteries of thyroid dysfunction and 

 thereby render its therapy more and more rational. 



BIBLIOGRAPHY 



1. McCaskey (G. W.) : The differential diagnosis of 

 hyperthyroidism by basal metabolism and alimen- 

 tary hyperglycemia, N. York M. J., 1919, ex, 607. 



