THERAPY 189 



Horsley proposed, in place of the human gland, to utilize the thyreoid of the 

 sheep in myxedema and cretinism, and Bettencourt and Serrano noted a rapid 

 improvement in a woman with myxedema, in whose abdomen they engrafted 

 one-half of a sheep's thyreoid. When Murray, instead of employing the entire 

 gland, subcutaneously injected its glycerin extract, and Mackenzie in 1892 

 administered the fresh gland or its extract internally with the same effect, 

 and other observers showed that the dried glandular substance in tablet form 

 acted in the same manner, the therapy of myxedema and of the related patho- 

 logic conditions previously mentioned became as simple as it was reliable. 

 In fact, reports came from all quarters regarding the almost remarkable action 

 of this " organotherapy," which was particularly effective in myxedema, in 

 infantile myxedema, and in cachexia strumipriva, while endemic cretinism, 

 owing to its nature, could only be benefited to a slighter extent. The tablets 

 which were administered were so prepared as to dosage that each tablet corre- 

 sponded to 0.35 gram of the glandular substance ; these were given in increas- 

 ing doses of from 3 to 7 or 10 tablets per day, until (early or later) symptoms 

 of intoxication, extreme or mild (the symptoms of so-called thyreoidism) 

 appear. 



It cannot be denied that the use of the entire gland has certain disadvan- 

 tages, on account of the varying amount of active substance in the individual 

 gland or tablet, the admixture of products of decomposition, etc. Obviously 

 it would be desirajjle to isolate and to utilize the specific active substance. 

 There have been numerous trials in this direction. At one time it was 

 hoped that the desired body could be obtained in the form of a ferment, at 

 another time it was supposed that it could be secured as a fixed chemical com- 

 bination from the group of proteid substances or even as an alkaloid. I must 

 mention that S. Fraenkel, in 1895, isolated a substance belonging to the 

 guanidin group with the empiric formula, CoITiilSTgOg, which he called " thyreo- 

 antitoxin," and Drechsel and Kocher, Jr., isolated similar combinations from 

 the gland. Then Baumann, in 1896, made the surprising discovery that the 

 gknd contained considerable amounts of iodin, and that this iodin was found 

 in combination with organic substances, chiefly in his opinion with albumin, 

 and to a smaller extent with globulin. This body Baumann called iodothyrin, 

 later thyreoiodin, and showed that from the purest thyreoiodin 9.3 per cent, 

 of iodin could be obtained in a crystalline form. Investigators are not yet quite 

 unanimous as to the true nature of this thyreoiodin. Tambach assumes that 

 the iodin is combined with various albumin bodies, and that iodothyrin forms 

 only a part of the iodin-containing substances of the thyreoid gland. Accord- 

 ing to Oswald, the iodin combined with albumin has the character of globulin, 

 for which reason he called it thyreoglobulin. Prom this, by long-continued 

 pepsin digestion, iodothyrin and iodin-containing albumoses and peptones can 

 be split off; Besides these, a nucleoproteid is said to occur which, however, 

 does not possess the specific action of the gland. Blum denies the presence 

 of iodothyrin as a primary constituent ; he thinks it is not preformed but is 

 an artificial cleavage-product. However this may be, Baumann in associa- 

 tion with Eoos seemed to prove that thyreoiodin possesses the specific proper- 

 ties of the natural gland, and acts as a substitute for its curative effects; it 



