THE THYROID AND PARATHYROIDS 293 



are always secondary to some more fundamental cause, and 

 that there is a hypersecretion quantitatively, but a hyposecre- 

 tion qualitatively (physiologically) ; and, lastly, that the usual 

 final stage of all cases, unless terminated by death or relative 

 recovery, is myxoedema. 



Reid Hunt has recently found that when small amounts of 

 thyroid are administered to mice for a few days the animals 

 acquire markedly increased resistance to poisoning by acetoni- 

 trile. This is believed to be an exceedingly delicate test for 

 thyroid substance. It was found, moreover, that it required 

 nearly twice as much acetonitrile to kill mice which had been 

 fed upon blood from a case of exophthalmic goitre as it did to 

 kill those which had received normal blood. This experiment, 

 Hunt believes, shows that the blood of patients suffering from 

 exophthalmic goitre contains an excessive amount of thyroid 

 secretion . 



Apart from surgical proceedings, the treatment consists 

 in absolute rest with the assistance of sedatives if necessary. 

 Serum therapy in the form of Rogers' and Beebe's serum, 

 Rodagen (from the milk of thyroidectomised goats), Anti- 

 thyroidin and Thyroidectin, may be tried. Local application 

 of iodine preparations may do some good. 



If surgical means be employed, we are not yet in a position 

 to state how much of the thyroid gland should be removed 

 in any given case. But in some instances it may be advisable 

 to remove more than one lobe, and it is recommended that 

 a small part of each should be left behind in order to preserve 

 with sufficient certainty the parathyroid glandules. 



6. Other Conditions due to Thyroid Disorder. 

 Leopold-Levy and H. de Rothschild believe that in addition 

 to " la grande insuffisance thyroidienne " there exists a " petite 

 insuffisance thyroidienne." Under this category they describe 

 a great variety of constitutional and local changes which they 

 ascribe to inadequate action of the thyroid. The -symptoms 

 are of the same general character as in myxcedema, only 

 less pronounced. They may, moreover, be complicated by 

 those of hyperthyroidism, or of perverted action of other 

 glands. They describe changes in general appearance, lowering 

 of temperature, loss of appetite, swelling of the salivary glands, 

 delayed development of teeth, dyspepsia, constipation, 



