190 MYXEDEMA 



also possesses the same toxic action, but has the advantages of a more exact 

 dosage and absolute purity. These opinions were soon confirmed by others 

 (Hofmeister, Ewald, Hennig, Goldmann, and others), so that there can be 

 no doubt that thyreoiodin may be employed in place of the natural gland. 

 Whether it is actually an equivalent for the complete gland appears doubtful 

 from the investigations of Gottlieb and Jaquet, -who observed in a number of 

 dogs after thyreoidectomy that thyreoiodin alone did not keep the animals 

 alive, while Gottlieb by administering an extract from the complete gland 

 (thyraden), and Jaquet by a substance called by him aiodin (a tannin precipi- 

 tate of the extract of the gland with physiological salt solution) succeeded 

 in sustaining them. I might also mention that Cunningham in England 

 isolated a so-called colloid substance from the gland which is analogous to 

 Baumann's thyreoiodin, i. e., the contents of the acini after previous peptic 

 digestion of the gland tissue. He is consequently of the opinion that this 

 colloid is the true active extractive product of the gland cell, while Oswald 

 believes it to be a mixture of thyreoglobulin and nucleoproteid. In a similar 

 manner, McLennan produced a preparation from iodoglobulin and thyreo- 

 iodin which has received the name thyreoglandin. In view of all this it is 

 obvious that the nature of the specifically active substance of the gland has 

 by no means been definitely decided; on the contrary, each day brings new 

 reports and new views. 



This is true also of another highly interesting discovery which science 

 owes to Baumann, who was unfortunately too early removed from his sphere 

 of activity. In a comparative estimation of the iodin contents of glands, 

 some of which were procured from Freiburg and some from Hamburg and 

 Berlin, it was shown that the iodin contents of the former were considerably 

 less than in the glands brought from the two last mentioned cities. The 

 glands obtained from Freiburg, in the same parts by weight, averaged 2.5 

 milligrams of iodin; those from Hamburg 3.83 milligrams, and those from 

 Berlin 6.6 milligrams; in the investigations in North America made by Gideon 

 Wells, the iodin contents of 20 glands, some from Chicago, some from Balti- 

 more, Boston, New York, etc., averaged 10.79 milligrams. Now, in Frei- 

 burg goiter is endemic and frequent, in Berlin and Hamburg comparatively 

 rare, in America almost unknown. What can be more reasonable than to 

 connect the slight amount of iodin in the glands from Freiburg (where, as 

 may be remarked in passing, goiter is found conspicuously often even in the 

 new-born and in young children) with the prevalence there of goiter? For 

 many years strumous degeneration has been referred to a lack of iodin in the 

 water, in the air, in the food, though no convincing proof of this has been 

 established. Here, for the first time, we seem to have analytic evidence of the 

 influence of iodin upon the development of goiter, or, more correctly, the 

 relations of the iodin contents of the thyreoid gland to goiter. I expressly say 

 " seem to have evidence," for to make this assumption a certainty more com- 

 prehensive investigations are necessary, and I am forced to admit that Oswald 

 made numerous analyses of glands from Switzerland and from the regioiis 

 where goiter occurs endemically and has demonstrated the exact opposite; 

 namely, that the amount of iodin in glands from this district Was greater than 



