Chemico-Functional Inteyration 115 



apparatus, and from tlie non-glandular a jxjrtion of the 

 alimentary nuicous membrane, namely, that of the duo- 

 denum. 



Effects of liemoving the Human TliifroUl for Curative 



Purposes 



As definite knowled^-e of the ^'reat [)hyslolo^ieal impor- 

 tance of internal secretions beg-ins with human surgery — 

 with operations on the thyroid aj)paratus — we may well 

 begin our study here. This is the better starting })oint 

 in that there is no more striking illustration of how great 

 a part of the whole organism ma}' be implicated in the 

 action of internal secretions than is afforded by the jjrod- 

 ucts of the thyroids and parathyroids. 



The subject first came into clear lif^ht in the early eii^hties 

 of the last century through the experiences of Swiss sur- 

 geons, Theodor Kocher and J. L. Reverdin esj>ecially, who 

 removed the thyroids to cure goitre, this disease being s})e- 

 cially prevalent in some parts of Switzerland. The })atients 

 operated on were found to improve ra])idly for a time after 

 the operation, but later untoward symptoms began to mani- 

 fest themselves. Because the variety and ]X'rvasiveness of 

 these symptoms in a typical case are highly instructive for 

 us we present them in detail, selecting a description from 

 Human Physiology by Luciani: "Patients who have under- 

 gone total thyroidectomy . . . experience the initial symp- 

 toms of glandular deficiency either at once or at latest some 

 weeks after the operation. They feel weak, com])laiii of 

 heaviness of the limbs, and more or less diffuse dull pains, 

 ])articularly in the legs, which may iH'come acute and assume 

 tlic character of ])airis in the bones. 



"Other more serious symptoms arc gradually associati'd 

 with the preceding. After four or five months the face 

 and the extremities swell and become cold, the nmscles are 



