ORGANOTHERAPY AND HORMONOTHERAPY 95 



of hyperthyroidism, on the grounds that it rarely if ever proves beneficial, 

 and that, by no means rarely, its effects are most harmful. Moebius, 

 at a time when this view was by no means general, insisted most strongly 

 that in this disease thyroid should not be given ; Biedl has expressed his 

 belief that its administration to these cases is always followed by bad 

 results, and A. Kocher says emphatically that "the avoidance of thyroid 

 or iodin administration is the first and most important indication" in the 

 treatment of Basedow's disease. Von Jauregg's opinion is that "as this 

 disease is looked upon as a condition of hyperfunction of the thyroid, it 

 is to be expected that thyroid therapy will act unfavorably and aggra- 

 vate it," and that "this expectation has been fulfilled by the results of 

 trial." The last named writer is also convinced that it is contraindicated, 

 not only in well developed cases, but also in cases of latent Graves' disease. 

 Bram, in his recent book on exophthalmic goiter, mentions this treatment 

 only for the purpose of condemning it except in cases which show signs 

 of hypothyroidism. If necessary, a much longer list of such condemnatory 

 opinions could be compiled, but it is believed that these sufficiently repre- 

 sent the views held by the majority of those who have had a sufficiently 

 large clinical experience. 



While these views and others of like import are based in part on the 

 assumption that thyroid administration must of necessity act harmfully 

 on patients already suffering from the results of over-activity of this gland, 

 it would appear that they have received ample confirmation in the follow- 

 ing indisputable facts. It has been the experience of at least a large 

 majority of competent clinicians, who have had the opportunity to observe 

 the effects of thyroid administration to patients suffering with this disease, 

 that these effects have rarely if ever been beneficial but have almost always 

 been harmful and in some instances fatal. 8 In addition a number of 

 cases have been reported in which thyroid medication was responsible for 

 the development of Graves' disease. 



On the other hand, at one time, not so long past, a considerable number 

 of physicians was of the opinion that thyroid therapy was at least occa- 

 sionally productive of distinctly beneficial results. Of late the adherents 

 of this view appear to have become less numerous, for in the recent litera- 

 ture this treatment is advocated less frequently. Among those who still 

 believe that there are cases of Graves' disease, which, under certain con- 

 ditions, are benefited by small doses of thyroid, is Rogers of New York. 9 

 As a justification for belief in the efficiency of thyroid medication in cer- 



8 It is noteworthy that Forchheimer, who believed that a small percentage of these 

 cases were benefited and some cured under thyroid or iodin treatment, stated that 

 the only fatal result, which he had seen in an experience of over thirty years, was due 

 to thyroid feeding. 



9 While I have not been able either to grant his premises or to follow his reason- 

 ing, the reports of the successful employment of thyroid medication, which have been 

 made by Rogers are such that they cannot be rejected offhand. As, however, this sec- 

 tion of this work deals only with the thyroid therapy of Graves' disease and Rogers' 



