Il6 THE DISEASES OF THE THYROID GLAND 



of the genital apparatus (Landau, Szanto}. In two women with distinct 

 cachexia strumipriva, Langhans found pronounced small-cystic degenera- 

 tion of the ovaries. Allen Starr, Kirk, Schotten and after them many others 

 have testified to the occurrence of menorrhagia. In men, libido is lost. 

 Very instructive in this connection is a case of Magnus-Levy, in which a fifty- 

 four-year-old man lost libido completely, and regained it after cure of his ill- 

 ness. Herz observed a similar case in which a forty-five-year-old man re- 

 gained erections and ejaculations two weeks after the beginning of treatment. 

 Treatment by thyroid gland also affects favorably the menstrual disturbances 

 in women. These do not signify sterility, as there are cases of myxedema 

 that become normally pregnant. It is shown also by animal experimenta- 

 tion (Hoisted} that partial extirpation of the thyroid does not prevent normal 

 carrying of young. In such cases the thyroids of the fetuses seemed to act 

 compensatorily. In other words, Hoisted observed in the new-born pups 

 an enormous hypertrophy of this organ. The thyroids were about twenty 

 times as large as in a normal new-born pup. In cases with a long-standing 

 high-grade deficiency of thyroid function, there occurs atrophy of the ovaries. 

 In this case the disturbance seems to be irreparable. 



In cases of myxedema the hypophysis is commonly described as altered. 

 Boyce and Beadles found enlargement of this organ, as did also Ponfick in a 

 case. In a case of Abrikosojf's the glandular portion of the hypophysis was 

 enlarged, and indeed the chromophilic cell-columns were increased, the cells 

 enlarged, their protoplasm showing colloid degeneration. Comte earlier ob- 

 served a similar condition and considered the enlargement of the hypophysis 

 as a compensatory hypertrophy. In other cases there has occurred a 

 pronounced sclerotic degeneration of the glandular hypophysis (2nd case of 

 Ponfick} or cystic degeneration (Sainton and Rathery, and others}. In both 

 the cases of myxedema above reported sella turcica as shown by X-ray 

 was normal. 



An enlargement of the hypophysis after extirpation of the thyroid has 

 been observed in animal experimentation. In grown animals, Bertelli and 

 myself (reports not published in detail) could not find anything similar after 

 a one and one-half years' duration of the thyroprivic condition. I think 

 that the findings described are overestimated as to their significance for the 

 reciprocal action between thyroid gland and the glandular hypophysis. The 

 vicarious action of the hypophysis for the thyroid gland, as Comte assumed, 

 need not be considered in this connection. It is just as if in contracted 

 kidney the liver acts vicariously for the kidney. In myxedema adultorum 

 the hypophysis sustains mostly changes of a strumous character, or simultane- 

 ously with these, changes of a chronic inflammatory nature (as for example 

 in the cases of Ponfick, Sainton and Rathery, et al.}, such as we shall meet 

 with again in the consideration of multiple ductless glandular sclerosis. 

 Simultaneous disease of the thyroid gland and the glandular hypophysis 



