OKGANOTHEBAPY AND HOKMONOTHEKAPY 105 



directly caused by dysfunction of this gland. 20 McLeod considers it 

 especially useful in chronic cases and states that the successful dose is 

 sometimes small and sometimes large and can be determined only by 

 trial. 



On account of the superficial similarity of scleroderma and ichthyosis 

 to the condition of the skin in myxedema these affections have also been 

 looked upon as possibly of thyroid causation and treated accordingly. The 

 results have been variable, the failures outnumbering even partial suc- 

 cesses. In eczema results have been very doubtful except in cases other- 

 wise suggestive of hypothyroidism and the same may be said of the 

 results in cases of alopecia. Although successful thyroid treatment of 

 juvenile warts, keloid, lupus vulgaris, urticaria, pruritus, and various other 

 conditions of the skin have been reported from time to time, the connection 

 between the treatment and the cures reported is doubtful. 



The unsatisfactory state of our knowledge as to the significance of 

 the thyroid and status of thyroid treatment in dermatological practice is 

 well exemplified in recent articles by McLeod, Foerster, and Pulay. It 

 would appear that it is occasionally useful in a moderate number of 

 different affections as noted above, but that its greatest usefulness is in 

 its administration to patients suffering from various types of skin disease, 

 who are also hypothyroid. . McLeod states that in dermatological practice 

 it is best to start with small doses which may be 1 increased if no results are 

 obtained. 



Blood Dyscrasias. Thyroid medication has also been reported as 

 beneficial in hemophilia, as in Pugh's case, in hemorrhagic conditions, such 

 as purpura, and in epistaxis, in which Waller states that, as it sometimes 

 retards and sometimes accelerates coagulation, it may prove either useful 

 or harmful, but to me it seems extremely doubtful that it exerts any influ- 

 ence in such cases. 



The Parathyroid Gland 



Our knowledge of the functions and significance of the parathyroid 

 glands has been derived from three sources, the results of their extirpation 

 in animals and man, post-mortem findings in cases of tetany, and observa- 

 tion of the effects of implantation of parathyroid tissue and of adminis- 

 tration of parathyroid substance to parathyroidectomized animals and to 

 human cases of tetany. 



From observation of the effects of extirpation it has been learned that 

 the removal of a sufficiently large portion of the glandular tissue is reg- 

 ularly followed by the development of tetany with fatal outcome. The 



20 A case has been reported by Ewald (quoted by von Jauregg) in which psoriasis 

 developed in a patient who was taking large doses of thyroid as a part of his obesity 



cure. 



