OKGANOTHERAPY AND HOKMONOTHERAPY 113 



always only temporary, although Barker states that treatment along these 

 lines can lead to cure or to such improvement that the dose may be 

 diminished. 



Exophthalmic Goiter. Salmon's conception of the role of the pitui- 

 tary in exophthalmic goiter led Eenon and Delille to investigate the ef- 

 fects of pituitary administration in this disease, and as they reported 

 beneficial results, it has also been used for this indication by a number of 

 others, many of whom have reported favorably as to its value, among them 

 being Hofstatter (&), Pal (c) (1915), and Claude, Baudouin, and Porak. 



Hofstatter reports in detail the results in 15 women, who had almost 

 without exception failed to improve under the methods of treatment ordi- 

 narily employed. He used preparations both of the whole gland and of 

 the posterior portion, administered either orally or hypodermically, but 

 found the injections decidedly more efficient. The usual duration of 

 treatment was four weeks, 12 injections of 1 c.cm. of the extract being 

 given three times a*veek. His conclusions (which appear well sustained 

 by the cases reported) are that the treatment adopted proved almost 

 without exception to be of distinct benefit. The exophthalmos and 

 goiter were only slightly influenced, or not at all, but the tremor, vasomotor 

 symptoms, hyperidrosis, psychic symptoms, asthenia or lack of energy, 

 and digestive disturbances were almost uniformly lessened or entirely 

 relieved. With a very few exceptions the menstrual disturbances (present 

 in all these cases) were promptly corrected, and the body weight increased. 

 The tachycardia also was usually favorably influenced. Pal (1915) re- 

 ports 16 cases thus treated. Of 9 cachectic cases, 7 gained weight, and 

 at the same time the restlessness, the tremor, and usually the hyperidrosis, 

 diminished. The exophthalmos was little (if at all) affected, while the 

 tachycardia improved only slowly, did not disappear entirely, and returned 

 when medication was discontinued. The thyroid often increased in size 

 during treatment. Some of these cases, originally so sick that operation 

 was considered inadvisable, showed such improvement under treatment 

 that they were later operated on successfully. In one case oral administra- 

 tion was followed by striking improvement, but in the others it was neces- 

 sary to give the drug hypodermically. Dosage was 0.25 to 1.0 c.cm. pitui- 

 trin. Claude, Badouin and Porak (1914) conclude that the pituitary is 

 not a specific in this disease, but that it exerts a favorable influence in 

 some cases. They report that the injections were often immediately 

 followed by a very striking lessening of the heart rate. Borchardt (&) 

 (1914) cites a number of other clinical reports by various observers in 

 which favorable results were recorded, but there are not lacking reports 

 of cases in which it was tried and failed. 



Hofstatter, without reaching any definite conclusions, devotes con- 

 siderable space to an attempt to explain the favorable results obtained 

 by himself and others. He offers several hypotheses for consideration: 



