10 2 JOHN T. HALSEY 



propriety of and benefit obtainable by the administration of thyroid to 

 epileptics, who are also hypothyroid, for it is a rule, to which there are 

 few exceptions, that whatever improves the general health of these cases 

 also exerts a favorable influence on the epileptic seizures. 



Enuresis. Early in his studies of patients suffering from myxedema 

 and milder degrees of hypothyroidism, Hertoghe (a) (6) called attention 

 to the frequent occurrence of enuresis in these cases and to its cure by 

 thyroid therapy. A little later and quite independently, Williams (a) was 

 led to try it in cases with this complaint and reported twenty-five cures in 

 the twenty-six thus treated. The remarkable thing about Williams' ex- 

 perience was that in most of these cases there was none of the usual signs of. 

 hypothyroidism. While from time to time Waller and others have reported 

 cure or amelioration of this distressing symptom from the administration 

 of thyroid, and although it is frequently referred to in textbooks, the treat- 

 ment would not appear to have become popular. The doses used should be 

 small, from !/> to 2 grains per diem. Too large doses seem to aggravate 

 the enuresis. 



Constipation. In the discussion of the effects of thyroid therapy in 

 myxedeina and other forms of hypothyroidism, mention has been made of 

 the frequency with which these patients suffer from constipation and of 

 the cure of this symptom by thyroid administration. These experiences 

 have suggested the trial of thyroid as a means of treating constipation in 

 other cases not obviously hypothyroid, but it is extremely doubtful if 

 its use for this indication is justifiable, unless there be a suspicion or cer- 

 tainty that the patient is hypothyroid. Waller has found it very useful 

 in pediatric practice, and often serviceable in diarrhea! 



Deafness. The improvement in hearing resulting from thyroid 

 therapy in myxedematous subjects, who so frequently are more or less 

 deaf, led Yulpius to investigate its effects in cases of deafness of other 

 causation. While ho reported benefit in a considerable proportion of his 

 cases, others who followed him (for literature, see von Jauregg, loc. cit., p 

 1 .">()) have not expressed themselves so favorably. According to Vulpius, 

 the most amenable cases were those with hypoplastic middle ear changes. 

 In old cases with sclerotic changes no favorable results were obtained, but 

 in cases of this kind in the moderately youthful the treatment was often 

 somewhat beneficial. The absence of any reference to thyroid therapy 

 in recent textbooks and articles dealing with the treatment of deafness 

 indicates that to-day otologists in general have little or no belief in its 

 value except in cases of hypothyroidism. 



Asthma. Lev v and Rothschild and others have maintained that 

 asthma is at least occasionally a manifestation of hypothyroidism and have 

 reported heneticial results from thyroid treatment. While, to me at 

 least, it is very improbable that asthma is often of thyroid origin, there 

 are certain reasons why it does not seem improbable that administration of 



