CHEMICAL REGULATION OF METABOLISM 383 



V 



properly, or, in later life, is extirpated, or injured by degenerative 

 changes. If the failure of the gland occurs in childhood, intellectual 

 development is arrested, and the condition known as Cretinism super- 

 venes. The expression is idiotic, the skin is greatly thickened through 

 the overdevelopment of connective tissue, and the features are conse- 

 quently coarsened and brutalized. In adults, extirpation or destruc- 

 tion of the gland by disease results in similar symptoms (Figs. 23 and 

 24) but the intelligence, although it becomes very sluggish, remains 



FIG. 24. The same patient as in Fig. 23, five months after thyroid administration. 



(After Kocher.) 



far above the level of an idiot. The temperature of the body is sub- 

 normal, the total metabolism is much reduced, and the daily nitrogen 

 output is subnormal. These conditions, if taken in hand early, are 

 completely curable by the administration of extracts or dried prepara- 

 tions of the thyroid gland. This is, in fact, the most completely success- 

 ful instance of organotherapy to which we are as yet able to point, and 

 provided the administration of the glandular preparations in appro- 

 priate dosage be continued, individuals who would otherwise exhibit 

 most extreme symptoms of the disorder remain in satisfactory health, 

 with unimpaired intelligence and vigor. 



