TREATMENT OF ATHYROSIS AND HYPOTHYROSIS 139 



Treatment of Athyrosis and Hypothyrosis 



Light grades of thyroid insufficiency may heal spontaneously or under the 

 use of thyroid-gland tablets (probably on account of the stimulating action 

 of the iodine they contain on the thyroid and on account of the raising of 

 all metabolic processes). In the severe cases, and especially those with com- 

 plete absence of the thyroid, an ideal therapy would be the implantation of 

 a new thyroid gland. 



Already A. Schijf tried to remedy the deficiency, in animals in whom the 

 thyroid gland had been extirpated, by the implantation of a new thyroid. 

 H. Bircher was the first, in 1889, to succeed in the implantation of a thyroid 

 in a case of very severe cachexia strumipriva. 1 He implanted with good re- 

 sults a human thyroid into the abdominal cavity ; there soon, however, occurred 

 a relapse. A new implantation brought about considerable improvement, 

 indeed even there was a return of the menses, which had ceased for a year; 

 but this result too was not permanent. Later Collins and Macpherson re- 

 ported results in myxedema that lasted from one and one-half to two years. 

 In these cases there were many renewed transplantations. Even more 

 favorable results are reported by Gibson and others in sporadic cretinism. 

 Horsley proposed that thyroids of monkeys or sheep be transplanted under the 

 skin of the breast, Rehn under the skin of the throat. New hopes were aroused 

 by the attempt of Payr to transplant thyroid tissue into the spleen, at first in 

 animals, later in a four-year-old case of sporadic cretinism. In the case last 

 mentioned the thyroid tissue came from the mothers. There occurred an 

 essential improvement which affected, in addition to the myxedematous 

 symptoms referable to the skin, also the intelligence and the growth of bone 

 (12 cm. in five months). But also in this case the result was not permanent. 

 Kocher suggested transplanting thyroid gland into the bone marrow. Mos- 

 zkowicz implanted thyroid-gland tissue into the tibia of a six-year-old myxe- 

 dematous child. Here too the result was good, but only transitory. (Per- 

 sonal communication.) Also the results attained by Bramann seem to have 

 been only transitory. 



New hopes have been awakened through the important investigations of 

 Carrel on the suture of vessels. Stick and Makkas succeeded in doing auto- 

 plasty on dogs; heteroplasty did not however succeed. Enderlen and Borst 

 come, on the ground of their interesting experiments, to the conclusion that 

 autotransplantation, that is, the transplantation of the thyroid gland from 

 one part of the body to another of the same individual represents per- 

 manent results. Homiotransplantation, that is the transplantation of the 

 thyroid gland of an individual to another of the same species, for instance, 

 from dog to dog, or from goat to goat, remained without results even when 

 tin- animals were from the same parents. The vessel suture indeed healed, 

 1 The experiments of v. Eiselsberg are of extraordinary interest for tetany and will be con- 

 sidered under that caption. 



