THE THYROID GLAND 51 



everyday calls by the ordinary post. It is with 

 the slow postal communications that we shall be 

 chiefly concerned in endocrine therapy; the 

 rapid effects that we see after strychnine, adrenal, 

 and pituitary injections are perhaps examples of 

 the telegraph methods from outside, but probably 

 cannot be compared for lasting efficiency with 

 the hormonic messages that direct our everyday 

 life. 



The correctness of our observations is proved 

 in a measure, both in children and in adults, by 

 the comparative results of total and partial 

 thyroidectomy. Kocher, of Berne, who has had 

 an unrivalled opportunity of judging, says, 

 " that if a quarter of the gland is left the symp- 

 toms of thyroid insufficiency do not appear." 

 This probably is true of immediate results, but 

 observation lasting over a period of years would 

 be needed before we could lay down a working 

 law. In children that most tiresome complaint 

 enuresis is often connected with hypothyroidism, 

 and will often yield to thyroid feeding when all 

 other treatment has failed. 



This weakness may continue, especially in 

 women, into adult life. In all cases thyroid 

 should be tried, and if by itself it fail, pitglandin 

 should be added, for this gland has a great 



