TREATMENT OF GOITRE AND NEURASTHENIA 133 



diastolic 70 mm., and temperature 100 deg. F., marked 

 insomnia, nervousness and tremor, diarrhea most of 

 the insomnia, and anterior pituitary compound one 

 gland lobes. I injected quinine and urea into the thy- 

 roid and prescribed small doses of sodium bromide for 

 the insomnia, and anterior pituitary compound one 

 capsule daily. Three months later the patient had 

 gained 10 pounds in weight, the pulse was down to 108 

 and the general symptoms had improved as the goitre 

 was reduced in size. 



Case 6. Mrs. J. F. M., aged 23, had had goitre for 

 two years, evidently caused by pregnancy. Examina- 

 tion May, 1920, disclosed symptoms of severe exoph- 

 thalmic goitre, including scanty menstruation, loss of 

 weight, marked insomnia, nervousness, diarrhea and 

 tremor, pulse 160, systolic pressure 150 mm., diastolic 

 85 mm., temperature 100 deg. F. There was a moderate 

 edema of the ankles. Quinine and urea injections were 

 made into the thyroid gland and the patient received 

 the anterior pituitary preparation, one capsule daily. 

 She improved rapidly. Now, four months after treat- 

 ment, the symptoms have disappeared and she has 

 gained 15 pounds. 



Case 7. Mrs. S. M. H., aged 29, suffered from severe 

 exophthalmic goitre for two months previous to exami- 

 nation May, 1920. During this time she had lost 20 

 pounds in weight. Marked insomnia, nervousness and 

 tremor. Pulse 130, temperature 99 deg. F. I injected 

 quinine and urea into the thyroid and prescribed the 

 same anterior pituitary formula, one capsule to be 

 taken daily. In four months this patient has gained 18 

 pounds, 7 pounds in the last three weeks. The goitre 

 has reduced in size, the symptoms of hyperthyroidism 

 are very much better and she is again doing her house- 

 work. 



Case 8. Miss E. B., aged 19, examination April, 

 1920. Complained of fatigue, nervousness, loss of 

 weight, insomnia, fatigability and other symptoms of 

 neurasthenia following scarlet fever two years previ- 

 ous. Pulse 90, systolic pressure 100 mm., diastolic 

 65 mm., temperature 97^ deg. F. I prescribed the 

 anterior pituitary formula, one capsule to be taken 

 twice daily. She gained steadily for one month when 

 her weight became stationary and she was instructed 



