GRAVES' DISEASE 87 



firstly, the lessening of the tremor and then of 

 the rapidity of the heart, but in long-standing 

 cases the treatment will need time and patience. 

 If, as sometimes happens, the heart has become 

 much dilated, a hypodermic injection of stro- 

 phanthin every other day will help much. Digi- 

 talis as a rule disagrees. The diarrhoea and colitis 

 are generally controlled, and they may be cured 

 by the following mixture, which is mildly bacteri- 

 cidal, but very comforting : 



Bismuth salicylat, gr. 12 



Liq. hydrarg. perchlor, m. 3 



Pulv. tragacanth co., 9 s. 



Tinct. chloroform et morph. co., gr. 15 



(B.P. 1885) 

 Aq. ad i ; ter die semund. 



I maintain that the details of this treatment 

 are in accordance with our present knowledge of 

 the causation of the disease and with our present 

 knowledge of endocrinology. The use of X-rays, 

 if carefully and judiciously used, helps much to 

 subdue the thyroid hyperactivity, but they do 

 not go to the root of things, and only treat a 

 symptom ; but in this disease, as in most, we 

 cannot afford to despise any outside help. 



With regard to partial thyroidectomy, I feel very 

 jealous. I feel that the calling in of surgical help 

 is a grave reflection on the physician. There may 



