OKGANOTHEKAPY AND HORMONOTHEBAPY 143 



would appear to justify the conclusion that in some of them administration 

 of thymus appears to be occasionally of benefit, that in others it is of doubt- 

 ful value, while in still others there is no real evidence that it is of any 

 value at all. 



Exophthalmic Goiter. In 1893 Owen reported marked improvement 

 in a case of Graves' disease, following the administration (through mistake 

 of a butcher) of thymus gland in place of thyroid. As he found that 

 cessation of thymus medication was followed by relapse and its resumption 

 by renewed improvement, Owen naturally concluded that the thymus 

 therapy was responsible for the improvement noted. Following Owen's 

 publication a number of clinicians, among others Von Mikulicz, reported 

 beneficial results following thymus feeding in patients with exophthalmic 

 goiter and also in those with simple goiter. While, as is usually the case 

 with new methods of treatment, the early reports were those of practically 

 uniform success, more extensive experience soon showed that this en- 

 thusiasm was not justified by the facts, and that in the majority of cases 

 of this disease thymus feeding is followed by little, if any, benefit. Of 

 late it would appear that this treatment has been used less frequently, 

 perhaps, than it should be, in view of the undoubted improvement which, 

 according to many capable clinicians, has followed its administration. 

 Kocher (&), in a recent publication, states that in his own experience thy- 

 mus feeding was followed in one-half of the cases in which it was tried by 

 improvement, which was never very striking, and that, even in doses of 

 100 grams daily, it caused no bad effects. He states, however, that it 

 was not well borne in three cases. He prefers to use Poehl's Thymin, of 

 which he usually gives 2 to 6 tablets (0.5 gm.) daily for three to six 

 weeks, starting with the smaller dose and increasing gradually. Bram, in 

 his recent book, quotes varying opinions as to its value. 



In view of the present divergence of opinion as to the exact nature of 

 the perversion of function in Graves' disease and of the uncertainty as to 

 the physiological significance of the thymus and its internal secretion, 

 the clinical results of thymus therapy furnish the sole criterion for an 

 estimate of its value in this disease. These results appear to be in some, 

 cases at least of sufficient value to justify its trial in cases not responding 

 satisfactorily to other treatment. 48 



If thymus feeding is actually beneficial in exophthalmic goiter it 

 would seem almost certain that it cannot exert any favorable influence in 

 cases of myxedema and cretinism, and yet Basch (c) is able to cite authors 

 reporting favorable results in these conditions of hypothyroidism. 



48 Arguments from a theoretical standpoint against the possibility that thymus 

 administration can exert a favorable influence in Graves' disease are the fact that the 

 thymus is often much enlarged in severe cases, the claim of Capelle and Bayer (who 

 believe that an internal secretion of the thymus aggravates the symptoms of this 

 disease, especially the tachycardia) that they have seen improvement following thy- 

 mectomy, and Bircher's claim that in animals implantation of thymus causes symp- 

 toms of Graves' disease such as tachycardia and tremor. 



