OKGANOTHEKAPY AND HOKMONOTHEBAPY 99 



in certain instances no thoroughly adequate explanation has yet been 

 furnished, while, for the beneficial effects obtained in others of this group, 

 a more or less sufficient explanation is furnished by the known physio- 

 logical effects of thyroid administration. 



Rheumatism (Articular and Muscular) .The frequency with which 

 patients with myxedema suffer from so-called rheumatism and the bene- 

 ficial effects exerted thereon by thyroid therapy have suggested that even a 

 minor degree of hypothyroidism may play a causative role in certain 

 cases of arthritis X1 and that thyroid therapy would prove beneficial under 

 these conditions. As in an overwhelmingly large proportion of cases of 

 arthritis there is an element of infection, and, as there are grounds for 

 believing that the thyroid gland exerts at least some influence on the 

 processes of immunity, 12 it is not illogical to assume that even a slight 

 degree of hypothyroidism will render an individual abnormally susceptible 

 to joint infection, and that in such a case thyroid, by augmenting the 

 formation of antibodies, would assist in overcoming the infection. Accord- 

 ing to fairly numerous clinical reports (among others, of Hertoghe, Leo- 

 pold-Levi and Rothschild), thyroid administration has often proven strik- 

 ingly beneficial in "rheumatic" patients, and that, too, in patients not 

 otherwise suggesting hypothyroidism. Such observations by no means in- 

 dicate that all cases of so-called rheumatism will be benefited by thyroid 

 therapy, as some enthusiasts would appear to believe, but "rheumatic" 

 symptoms, especially in the middle aged and elderly people, respond to it 

 favorably often enough to justify its trial, in conjunction with other 

 measures of known value, such as removal of infectious foci. I am con- 

 vinced that I have greatly helped some of my patients with subacute or 

 chronic arthritis or with "muscular rheumatism" by giving them thyroid 

 in doses of % to 1 or 2 grains daily. 



Diseases of the Bones (Rickets). Among other conditions in which 

 hypothyroidism has been thought to play a causal role is rickets, but it is 

 reasonably certain that thyroid dysfunction is only occasionally, if ever, 

 responsible for the development of this disease. From the results of feed- 

 ing thyroid to rachitic children as reported by various authors (see von 

 Jauregg, loc. cit., p. 140) it is extremely doubtful whether this is of any 

 value whatever except in cases which are also hypothyroid, in which case 

 one may well attribute the favorable changes noted to the glandular 

 therapy. Thyroid administration is indicated in rachitic cases only if 

 there be a certainty or a suspicion of hypothyroidism. 



In delayed union following fractures, thyroid therapy has been em- 



11 In this connection much interest attaches to a case reported by Acchiote", in 

 which arthritis developed in a woman, whose thyroid became atrophied as a result of 

 X-ray treatment, and whose "rheumatism" was promptly cured by thyroid admin- 

 istration. 



12 See discussion on use of thyroid in infectious diseases (p. 103) . 



