12 THE THYROID AND 



f There are four main varieties of iodoform poi- 

 soning : 



i. Skin eruptions, such as dermatitis, erythema, 

 and swelling. 



?~ Persistent subjective taste and smell of the 

 drug long after its application has been discontinued. 



3. Toxic amblyopia (5 cases), and optic atrophy 

 (i case). 



4. Acute thyroid symptoms, comprising rapid 

 pulse, delirium, headache, vomiting, and a variable 

 amount of fever. The most characteristic sequence 

 is when the pulse is very rapid but the temperature 

 normal. 



Of the above groups we are now concerned 

 only with the last. 



It will be noticed that the clinical picture cor- 

 responds exactly with that seen after the adminis- 

 tration of excessive doses of thyroid extract. Iodo- 

 form causes its toxic effects by stimulating the 

 internal secretion of the thyroid gland, with the 

 production of acute thyroid intoxication. 



I have described a case in which chronic thyroid 

 intoxication, that is to say Graves' disease, clearly 

 followed the application of iodoform to an absorbing 

 surface. There was certain proof that too much 

 iodoform was absorbed, because for weeks after the 

 drug had been withdrawn the patient was haunted 

 by its smell and taste. The tachycardia and wasting 

 were first noticed a week or two after this symptom 

 developed. The Graves' disease was still present in 

 a mild form one year later, but eventually disappeared. 



Hunt and Seidel have sho\vn that after dosing 



