ORGANOTHERAPY AND HORMONOTHERAPY 87 



Therapeutic Employment of Thyroid Preparations 



Thyroid therapy produces its most remarkable and valuable ther- 

 apeutic effects in myxedema and cretinism, that is, in conditions clearly 

 due to absence or deficiency of the thyroid function. It has also been 

 employed in the treatment of a large number of diseases or conditions, 

 in some of which there is more or less reason for believing that hypo- 

 function or dysfunction of the thyroid plays a causal role. In other condi- 

 tions in which it is claimed that this therapy is of benefit, there are not suf- 

 ficient grounds for the assumption of faulty thyroid function, and the justi- 

 fication for its employment must be sought in assuming that it acts symp- 

 tomatically. 



Myxedema and Cretinism. Organotherapy obtained its first and, up 

 to the present date, its greatest triumph when in 1891 Murray, inspired 

 by Bettencourt and Serrano's fairly satisfactory results from transplanta- 

 tion of a sheep's thyroid in a case of myxedema, undertook to treat a, case 

 of myxedema by the subcutaneous injection of a thyroid extract. The 

 brilliant success of thyroid therapy in this historical case is known to 

 all and is manifest in the fact that by thyroid administration this 

 woman, a pronounced case of myxedema of twelve years' standing, was 

 promptly restored to and maintained in good health for nearly thirty years, 

 up to the time of her death a few months ago. Very soon it was found 

 by Hector Mackenzie and by Horwitz that the oral administration was 

 just as efficient as, and far less inconvenient than, the injections. 

 Physicians everywhere adopted the treatment and quickly obtained sim- 

 ilar brilliant cures in myxedema, both the spontaneous form and that 

 occurring after removal of the gland (cachexia strumipriva), and a 

 little later, in cases of cretinism. To-day the value of this treatment 

 is universally recognized and the method of its application is well 

 known. 



The remarkable change wrought by it in the condition of the patients 

 must be seen to be believed. In cases of myxedema the usual result is a 

 complete cure with disappearance of all the symptoms. The results have 

 been well described by v. Jauregg: "One of the first signs of improve- 

 ment is the rise to a normal level of the formerly subnormal temperature 

 which leads to the disappearance of the great sensitiveness to cold. Coin- 

 cidentally the pulse becomes more frequent. In a few days the effect on 

 the skin is manifest, the edema and thickening diminishing and eventually 

 completely disappearing so that the skin becomes soft and smooth, and is 

 no longer abnormally dry as the sweat glands resume their function. The 

 hair grows better, that on the head becomes longer and thicker and is no 

 longer dry and brittle. Often the hair returns even on entirely bald spots, 

 and the scanty or absent eyebrows are renewed. As a result of the changes 



