88 JOHN T. HALSEY 



in the skin and subcutaneous tissues, the lace and hands regain their 

 natural appearance and the stiffness in the limbs disappears. There is a 

 loss of weight which may amount to as much as forty pounds or even more. 

 The feelings of weakness and fatigue, so characteristic of these patients, 

 are replaced by consciousness of increased energy and desire for activity, 

 the movements of the patient becoming quicker and more dextrous. The 

 mental condition also improves rapidly, memory returning, and under- 

 standing and will power increasing. The sleepiness or stolidity is suc- 

 ceeded by a more normal state of mind, the patient becoming more talk- 

 ative and beginning to take a normal interest in his environment so that 

 he is no longer moody and depressed." Even when there has been a real 

 mental disturbance, this is usually completely cured, although in some 

 cases there may be complete restoration of the general health without cure 

 of the mental disturbance. The appetite and digestion improve, constipa- 

 tion is relieved, and diuresis increases. The more or less atrophied 

 genitalia return to a normal state in patients sufficiently mature, and 

 menstruation and other genital functions are restored. 



In cretins thyroid therapy also produces most remarkable results, the 

 most constant of which is the effect on growth. Under the influence of 

 thyroid feeding this is markedly stimulated even in subjects who for 

 years had not increased in stature and who had arrived at an age in which, 

 in normal individuals, growth has ceased. 



In forty-nine out of fifty-one cretins to whom thyroid -was administered 

 for from three to six years, von Janregg obtained an increase of stature, 

 which exceeded the normal average for the corresponding age and inter- 

 vals ; and others have published large series with similar results. Most of 

 the following figures are quoted from v. Janregg; increased growth in fifty- 

 two of fifty-nine cases treated for from one to three years (v. Eysselt) ; in 

 s r>.7 per cent of 440 cases under treatment for from one to one and one- 

 half years (Kutschera von Aichberger), among which were two subjects 

 aged 25 and 2(> years, who grew 3 cm. and 7.5 cm. ; in twenty-three of his 

 own series of fifty-one cases von Jauregg obtained a growth ranging from 

 10 to 15.;") cm. during one year of treatment, one subject, 27 years old, 

 grow ing 4 cm., another, 23 years old, 12.5 cm., while a third, a girl of 

 nineteen, increased her height from 107 to 135 cm., and a fourth under 

 treatment from his fifteenth to his twenty-second year, increased his 

 stature from 105 to 100 cm. (from 42 to G4 inches). Of v. Eyselt's cases, 

 four subjects, aged from 20 to 23 years, grew from 6.5 to 22.5 cm. 

 and Christoffersen's patient of 45 years grew 5 cm. 



The rate of growth is greatest during the first year of treatment, after 

 that, gradually approaching the normal. In v. Jauregg's own series the 

 average, growth in successive years of treatment was 9.5, 6.3, 5.5 and 5.7 

 centimeters. 



If treatment is started early enough normal stature may be attained, 





