428 NELSON W. JANNEY 



The face enlarges, the nose and eyes become more prominent, the lips 

 become normal in size, the voice takes on its natural qualities, the pot-belly 

 and abdominal hernia disappear, the limbs grow proportionally the ex- 

 tremities losing their stubbiness. The muscles harden, the myxedema dis- 

 appears and the skin grows soft and moist. The normal mentality for the 

 age is regained to a greater or less degree. The gait and bodily move- 

 ments recover their agility. In course of months or years, a helpless, 

 drooling idiot may become transformed into a healthy beautiful child. 



The skin and its appendages undergo striking changes on proper treat- 

 ment. The texture, normal thickness, color, moisture and mobility of this 

 organ are quickly restored. The nails become normal. The hair be- 

 comes glossy, properly pigmented and plentiful areas of alopecia may soon 

 be covered with a downy new growth and later with normal hair. Strand- 

 berg reports renewed growth of hair in three of nine cases of alopecia 

 areata showing otherwise no thyroid symptoms. G. R. Murray, in Allbutt's 

 System of Medicine, has published a remarkable photograph of a bald male 

 myxedemic who three months later is again pictured with a heavy growth 

 of normal hair. McCarrison mentions a tendency of the hair to fall out 

 at the beginning of treatment, to be followed by a thick new growth. 

 Diffused hair sparseness is likewise favorably influenced by treatment. 

 The dentition may undergo an astonishing degree of development even 

 when greatly retarded. Thus Kassowitz's twenty-two-month-old cretin 

 was toothless, but sixteen teeth were erupted during the next six months 

 on treatment. Resumption of normal eruption periods of the permanent 

 teeth is one of the certain signs of general improvement. 



The mental improvement in myxedema on proper thyroid medication 

 is striking. The apathy disappears, the memory and the ability to con- 

 centrate return, the normal play of emotion sets in, and the usual mental 

 activities of the individual are resumed. Psychoses of subthyroid origin 

 may disappear completely under treatment. One of the writer's patients 

 eloquently described this great inward change by saying, "I stepped from 

 out the world of shadows and uncertainties into the bright sunlight of 

 vivid human existence, astounded beyond words to think and feel as a 

 normal man again. Each day teems with delightful experiences of a re- 

 newed existence." 



The special senses regain their activity early. Among the most inter- 

 esting effects is that on speech. Children, who previously could mutter 

 only "Papa" or "Mamma" begin to prattle freely. Normal chattiness re- 

 places the stupid silence of the cretin or myxedemic. Magnus-Levy refers 

 to the appearance of stuttering at the beginning of treatment. The writer 

 has observed slowing of the speech to the normal in the cases of psychoses 

 of tlio excitable type on a subthyroid basis. 



The secondary sexual characteristics may, under proper treatment, 

 develop long after the usual age of puberty has been passed. An interest- 



