THE THYROID 33 



avoid straining an already weakened heart; or an 

 ignoramus if he insists that the rest combined 

 with hygienic principles offers the best hope for 

 alleviating the disease. If he suggests trying a new 

 remedy he is experimenting with her ; if he persists 

 with the old he is a 'stick-in-the-mud.' " 



Dr. Cobb in his example deliberately uses the 

 feminine gender because the disease is really far 

 more common in the female than in the male. The 

 proportion is placed by some authorities as high 

 as five to one. An attempted explanation for this 

 "partiality" is based on the fact that in the female 

 the gland is enlarged usually at puberty and dur- 

 ing pregnancy. 



Treatment. When we come to the means at our 

 disposal in bringing about a cure, we find no such 

 definite road to success as in cases of hypothyroid- 

 ism. There, as will be remembered, definite 

 amounts of extracts of the thyroid gland, when 

 regularly administered, changed the secretion of 

 the gland from subnormal to that approaching nor- 

 mal. Here, with an excessive secretion, it might 

 be surmised that a partial removal of the gland 

 would be successful in restoring the health of the 

 sufferer. This has been tried many times, and 

 with success in a fair number of cases. But the 

 operation is a difficult one, and only a surgeon 

 of extraordinary skill and much experience can 

 perform it; and even then a successful operation 



