INTERNAL SECRETIONS 



359 



of the characteristic symptoms if one fails to remove the glands (Fano). 

 If only a part of the gland is left the symptoms do not appear, but hypertrophy 

 of the part remaining takes place. The disease of myxcedema in man also 

 speaks against such a view. And, finally, it is controverted absolutely by the 

 fact that intraperitoneal grafting protects the patient from the consequences 

 of thyroidectomy so long as the transplanted gland continues to be functional 

 (v. Eiselberg) ; if it atrophies, the usual symptoms appear. 



Likewise by subcutaneous injection of thyroid extract, as well as by ad- 

 ministration of thyroid preparations by the stomach (Howitz), the same favor- 



FIG. 137. A myxoedematous woman, after J. A. Andersson. A, before treatment. B, after 

 seven months' treatment with thyroid extract. 



able effect is obtained i. e., the harmful effects of the removal of the thyroid 

 can be prevented by artificially introducing thyroid substance into the body. 



It happens exceptionally that a dog, after extirpation of the thyroid, is not 

 attacked by the usual symptoms. In this case there are probably accessory 

 thyroids which have taken up the function of the main gland. 



The disturbances appearing after extirpation of the thyroid affect the most 

 widely different organ systems of the body. We shall now summarize them 

 briefly with special reference to their appearance in man. 



The skin, especially of the head and face, becomes greatly swollen (Fig. 

 137, A) because of an accumulation of mucin in the subcutaneous connective 

 tissue. In later stages of the disease the mucin decreases, and atrophic changes 

 of the connective-tissue fibers appear along with general emaciation. The skin 

 becomes hard, rough and dry ; its secretion ceases ; the hairs change and fall out ; 

 the visible mucous membranes become swollen ; and the voice becomes harsh 

 and monotonous. The internal organs exhibit marked pathological changes; 



