380 NELSON W. JANNEY 



mectomy but it was not until April, 1883, that his classical account of 

 Cachexia Tliyropriva in thirty cases appeared. A little later in the same 

 year, J. L. Reverdin recognized thyroidectomy as the etiologic factor of 

 surgical myxedema. Crotti has made a careful analysis of the Kocher- 

 Reverdin controversy which then ensued, and which chiefly served to 

 bring a thorough understanding of myxedema to the cognizance of the 

 medical world. 



Following the discovery of the cause of myxedema, came the thera- 

 peutic attempts of Sir Victor Horsley (/) and George Murray (a) in Eng- 

 land which led to the complete demonstration of the efficacy of thyroid 

 feeding in myxedema and cretinism. Hofmeister, Lanz, Vassale and Gen- 

 erali, Pineles and Erdheim (&) studied experimental athyrosis with im- 

 portant contributions. To Pineles we are indebted for the recognition of 

 thyroaplasia in man ; to Maresch for the first clear differentiation of hypo- 

 thyroidism from parathyroid disease. 



With regard to the metabolism of hypothyroidism, Magnus-Levy in 

 1807 made the remarkable discovery of the great depression of the same 

 which has since been confirmed by various workers. 



Great strides in the knowledge of the thyroid gland have been taken in 

 the decennium 1910-1920 in the United States. For the invention of the 

 respiration apparatus clinically applicable to studying thyroid disease, 

 scientific medicine owes much to Francis E. Benedict and Thome Carpen- 

 ter. Elucidation of the problem of diagnosis and treatment of hypothy- 

 roidism, with the aid of basal metabolic studies, has been aided by E. 

 DuBois, J. H. Means and J. C. Aub (&), H. Plummer and others. To E. C. 

 Kendall belongs the high credit of first isolating in pure form, chemically 

 identifying and synthesizing iliyroxin, the thyroid hormone ; and in con- 

 junction with H. Plummer, applying this compound to the clinical treat- 

 ment of hypothyroidism. 



Definition and Nomenclature 



The present chapter deals with morbid conditions caused by decrease 

 or loss of thyroid function as distinguished from Thyrotoxicosis (so-called 

 Hyperthyroidism and Exophthalmic Goiter) and DysiJiyroidism. 



Our present want of fundamental knowledge of many thyroid problems 

 unfortunately invites criticism of any possible classification of thyroid 

 diseases. Thus certain authorities argue on just grounds that Thyrotoxi- 

 cosis is likewise accompanied by loss of normal thyroid function as well 

 as by well-known toxic symptoms. Doubtless also the state of Dysthy- 

 roidism may be truly regarded as due, at least in part, to defective thyroid 

 function. ' For purposes of description, however, the classification adopted 

 in the present work seems advisable. Accordingly, the subject of 



