86 THE THYROID AND 



to expect good from partial removal, which has been 

 very successful in the hands of Kocher, the Mayos, 

 and others. It would be reasonable also to try the 

 effect of iodine starvation, by eliminating vegetables 

 and ordinary tap-water from the dietary, and sub- 

 stituting for the latter the water of a goitre well. It 

 is well known that exophthalmic goitre and parenchy- 

 matous goitre show a sort of geographical antagonism, 

 and the effect of the water in reducing the amount of 

 iodine available for conversion into iodothyrin would 

 be valuable. 



Further, we are helped to understand and to 

 recognize cases of iodoform poisoning, and to learn 

 caution in the use of this drug on absorbing 

 surfaces. It is safer in children than in adults, 

 possibly because the thyroid in children contains 

 less iodine. It ought not to be used in patients 

 who have ever shown a tendency to thyroidism, 

 lest acute poisoning or an attack of Graves' disease 

 be precipitated. 



Finally, we obtain a clue at last to the remarkable 

 action of iodides in arteriosclerosis and gummata, 

 and it is reasonable to hope that organic compounds 

 of iodine, which cause acute thyroidism more readily 

 than the alkahne salts, may be yet more effectual 

 in stimulating the activity of the thyroid gland. In 

 fact, thyroid extract itself may prove to be the 

 best remedy of all. 



Seeing that the activity of thyroid extracts 

 depends only on the iodothyrin, these should be 

 standardized chemically if they are to be given 

 as drugs. Leading chemists now issue an extract 



