494 CHEMICAL PATHOLOGY OF THE DUCTLESS GLANDS 



observed in the thyroid are usually quite the same as those of 

 compensatory hypertrophy, suggesting strongly that the goitrous 

 change of this disease is due to a true hypertrophy, with 

 increased production of the specific secretions. Also speaking 

 strongly in favor of the view that exophthalmic goiter is the 

 result of overactivity of the thyroid is the frequent cure of the 

 disease through removal of a large part of the diseased gland. 



Corroborative evidence of the hypersecretion idea, and also 

 of the theory that the normal function of the thyroid is the de- 

 toxication of metabolic products, seems to have been furnished 

 by the serum treatment advocated first by Ballet and Enriquez, 

 and later by Lanz, and Burghart and Blumenthal. 1 On the 

 principle that after thyroidectomy the blood should contain an 

 accumulation of those substances which the thyroid normally 

 neutralizes, they injected the serum of thyroidectomized goats 

 into patients with exophthalmic goiter, in the hope that these 

 accumulated substances might in turn neutralize any excessive 

 thyroid secretion. Favorable results were obtained, and it was 

 subsequently found that the milk of thyroidectomized goats 

 possesses the same qualities, and may be administered by mouth ; 

 this has led to quite extensive clinical use of this method of 

 treatment, which at the time of writing is in the experimental 

 stage. 2 Of similar significance are the favorable effects obtained 

 by Beebe 3 and Rogers 4 with a serum made by immunization of 

 animals with the nucleoproteids of the thyroid. 



Oswald 5 found that the thyroid in exophthalmic goiter con- 

 tains generally a smaller proportion of iodin than normal glands, 

 but with the total amount approximately normal. This was also 

 the result of two analyses that I have made. However, the find- 

 ings are very inconstant, corresponding with the fact that in some 

 cases of exophthalmic goiter the amount of colloid is abundant 

 (in which case the amount of iodin may be large), while usually 

 the amount of colloid is small, and its highly vacuolated condi- 

 tion in hardened sections suggests that it is of unusually fluid 

 consistency. These results, therefore, indicate nothing either 

 for or against the hypothesis that exophthalmic goiter is due to 

 autointoxication with the secretion of the thyroid. 



1 Deut. med. Woch., 1899 (25), 627. Also Mobius, Miincli. med. Woch. 

 1901 (48), 1853 ; v. Leyden, Med. Klinik, 1904 (1), 1 ; Eulenburg, fieri, klin. 

 Woch., 1905 (42), 3. 



2 Negative testimony as to the value of this treatment given by Heinze, 

 Deut. med. Woch., 1906 (32), 755. 



3 Jour. Amer. Med. Assoc., 1906 (46), 484 ; 1906 (47), 655. 



4 Ibid., 1906 (46), 487 ; 1906 (47), 661. 



5 Virchow's Arch., 1902 (169), 475. 



