THE THYROID APPARATUS J I 



ness of intestinal peristalsis, the insignificant effects produced by 

 pilocarpin, and the intensified action of atropin upon the eyes 

 (Asher). 



That thyroidectomy has an effect in reducing the metabolism 

 of fats has been proved by experiments. 



With regard to the metabolism of salts, Falta, Tedesco, and 

 Bolaffio found that dogs which had been thyroidectomized some 

 time previously did not show a decreased assimilation during the 

 first few days of the fasting state. Cases have been described, 

 however, where the excretion of the chlorides and the amount 

 of calcium, phosphorus and magnesia present in the urine were 

 decreased after thyroidectomy, while the amount of calcium and 

 phosphorus in the fasces and of magnesia in the urine became 

 increased after the exhibition of thyroid preparations (Falta). 



These results would seem to show that the suppression of the 

 thyroid function reduces the metabolism of salts in the same 

 way as it does that of albumin, though the two processes do not 

 proceed parallel to one another. 



ATHYROSIS AND HYPERTHYROSIS IN MAN. 



Sir William Gull (1873), under the title of " Cretinoid State 

 in Adult Life in Women," described a symptom-complex which, 

 later, was termed "myxcedema" by W. Ord (1877), and 

 " cachexie pachydermique " by Charcot (1879), and which was re- 

 garded, by both these authors, as a separate clinical entity. Curling, 

 at an earlier date, described the atrophy or absence of the thyroid 

 gland in sporadic cretinism ; and the pathogenetic significance of 

 the thyroid gland in myxcedema was suspected even at that date. 

 But until the publications of both Reverdin and Kocher in 

 1882-1883, the clinical conditions which follow suppression of 

 the thyroid were either unknown or w r ere unappreciated. These 

 authors, writing independently of one another, described the 

 symptoms which are observed after the total extirpation of a 

 degenerated thyroid gland. Reverdin named this condition 

 Myxoedeme postoperatoire ; Kocher called it Cachexia strumipriva. 



OPERATIVE ATHYROSIS. 



The most constant symptom of thyroid insufficiency in the 

 young growing individual, in man as in animals, is a remarkable 

 disturbance of the processes of growth. This takes the form of a 

 retardation of the growth in height, the growth in breadth con- 

 tinuing very much as in the normal (v. Bruns). The arrestation 

 of development produces a dwarf-like appearance of the individual, 

 due to imperfect endochondral ossification. The unclosed 

 epiphysial lines may be seen in skiagrams, and post-mortevii 

 examination shows that the ossification of the ends of the 



