86 INTERNAL SECRETION 



Payr describes one case of remarkable interest, that of a 

 child of 6 with extreme infantile myxcedema. The child was given 

 thyroid gland for 3^ years without result, but the implantation 

 in the spleen of a large portion of thyroid tissue taken from the 

 mother was followed by a marked improvement in both the 

 physical and mental conditions. 



Under certain conditions, and more particularly where the 

 exhibition of thyroid extract is negative, the transplantation of 

 healthy thyroid tissue has a distinct therapeutic value. As Salzer 

 conclusively shows, the site best suited for implantation is the 

 subcutaneous or preperitoneal tissue, for here the colloid secretion 

 is adequate, while the vascularization is certainly as profuse 

 as when the thyroid occupies its normal site, if not more so. 

 Moreover, as Christiani points out, in order to obtain a thera- 

 peutic result, it is frequently necessary to repeat the implantation, 

 and for this reason alone the subcutaneous or preperitoneal tissue 

 is preferable to the spleen or the bone. 



There is, however, but a limited field for surgical intervention, 

 the medical method supplying, in the great majority of cases, a 

 thyroid substitution which is not only of equal reliability, but 

 is far safer. 



The results of the treatment, by means of extracts and other 

 preparations of thyroid gland, of the pathological conditions 

 which follow the suppression of the thyroid function are not only 

 of profound interest, but they have a very important practical 

 application. The experimental material, though considerable, is 

 largely valueless, owing to the fact that substitution was almost 

 invariably attempted with a view to its effects in post-operative 

 tetany. It is certain that neither the exhibition of thyroid 

 preparations nor of the fresh thyroid gland can permanently 

 replace the complete thyroid apparatus ; that is to say, thyropara- 

 thyroidectomized animals cannot be kept alive by this means. 



There is a small amount of material forthcoming concerning 

 the beneficial effects of thyroid extract upon the pathological 

 changes, and especially the changes in growth in young animals, 

 which follow the suppression of the thyroid. Pick and Pineles 

 found that, in the case of thyroidectomized goats, the pathological 

 signs disappeared after the animals were given thyroglobulin and 

 the thyroid glands of swine. 



According to Coronedi, the functions of the thyroid and 

 parathyroids may be replaced by artificial organic halogen com- 

 pounds, fats containing biniodide and dibromide of stearic acid, 

 as well as by the iodine compounds contained in the thyroid 

 itself. Animals which are treated with these fats before thyro- 

 parathyroidectomy are said to be immune for a certain time from 

 its results. For instance, the hypertrophy of the hypophysis, 

 otherwise a constant feature, is not observed under these 

 conditions. 



