CLINICAL SYNDKOMES 369 



Upon the supposition that the enlargement of the thymus so frequently 

 found in Graves' disease is a compensatory phenomenon, thymus extract 

 was tried by Mikulicz, Solis-Cohen, Mackenzie and others. Mackenzie (&), 

 who gave it an extensive trial in twenty cases, noted no appreciable effect, 

 and goes still further when he states that he has not found any special 

 virtue in any of the gland preparations, separately or combined, in the 

 treatment of exophthalmic goiter. 



Gibson believes that the suprarenal extract has "no rival in the man- 

 agement of the affection," and states that the rate of the pulse is reduced, 

 the protrusion of the eyeballs disappears, the thyroid gland diminishes, 

 the tremor along with every other nervous symptom vanishes and the 

 patient is restored to health in a way that we never see from any other 

 method of treatment. While it is true that other clinicians have not 

 proved so enthusiastic about the gland extract, a short trial at least is in 

 our opinion worthy of consideration. 



Extracts of the pituitary gland have also been tried and may benefit 

 some of the minor phenomena as the fever, polyuria, polydipsia, the fat 

 deposition, etc., but, in the opinion of Hofstaetter and others, have no 

 effect upon the cardinal symptoms of the exophthalmic goiter. 



The spleen, ovarian and testicular extracts have also been tried from 

 time to time but without the slightest success. 



Serum Therapy. In 1895 Ballet and Enriquez endeavored to neu- 

 tralize the poison of the thyroid in nine cases of exophthalmic goiter by 

 administering the serum of thyroidectomized dogs and reported an im- 

 provement in the tremor, exophthalmos and struma. Lanz made similar 

 attempts with the milk of thyroidectomized goats and sheep. Burghart 

 used the blood of a myxedema patient, Moebius (c) the thyroid of a cretin. 

 Soon the manufacturing chemist prepared for clinical use several reme- 

 dies of this class, for example the "antithyroidin" of Moebius (dose 0.5 to 

 4 c.c. three times a day), which was made from the serum of thyroidec- 

 tomized sheep: also "rodagen" (dose 5 to 10 grams daily), which was 

 prepared from the milk of thyroidectomized goats, and lastly "thyroidec- 

 tin" (dose 5 to 50 grains three times a day) made from the blood of 

 thyroidectomized sheep. The supposed effects of these various prepara- 

 tions are about the same; the struma becomes smaller and softer, the 

 tachycardia is lessened and the mental irritability and the muscular weak- 

 ness are sometimes improved, though more often not. In a few patients 

 the improvement is prompt,, but in the majority the progress is slow. 

 Further, the dosage is a matter of guesswork since we do not know how 

 much toxin has to be neutralized nor how much antitoxin there is in 

 a given amount of the preparation. It is possible that the isolation of 

 the active principle of the thyroid gland in a pure chemical form as 

 has been done by Kendall will be the first step in overcoming such diffi- 

 culties. Eor the present if one wishes to try these remedies one must 





