Page images
PDF
EPUB
[blocks in formation]
[ocr errors]

Proper Method of Room Disinfection

Wisconsin Eclectic Medical College.

Wood, W. C. Vesical Calculi...

[blocks in formation]

..June
821

67

741

37

418, 599

291, 502

July

60

[subsumed][subsumed][subsumed][subsumed][subsumed][subsumed][subsumed][subsumed][subsumed][subsumed][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][graphic]

AUG 10 1898

LIBRARY

THE

BROOKLYN MEDICAL JOURNAL

4585

Published Monthly under the supervision of the Medical Society of the County of Kings.
ENTERED AT BROOKLYN, N. Y. POST OFFICE AS SECOND CLASS MATTER.

[blocks in formation]

No paper published or to be published elsewhere as original will be accepted in this department.

CRETINOID MYXEDEMA AND ITS TREATMENT BY
THYROID GLAND.

BY JOHN C. SHAW, M. D.

The first description of sporadic cretinism was published by Mr. Curling in 1850. In 1871, Mr. Hilton Fagg gave a fuller account of the disease and recognized the resemblance between sporadic cretinism and endemic cretinism, a condition which had been known for a great many years. Fagg's description was so accurate that not much has since been added; he also spoke of the wasting of the thyroid body, "if that should prove to be a constant character of the disease." The similar condition found in the adult was first publicly described by Sir William Gull in 1873, in an article entitled "On a Cretinoid State Supervening in AdultLife in Women," the condition now known as myxedema. Later, in 1877, an exhaustive study of the disease, as observed in the adult, was made by Dr. Ord, and the name myxedema suggested by him, because in one of his cases a large quantity of mucin was found in the subcutaneous tissue. Kocher observed that total extirpation of the thyroid gland caused a condition similar to myx

edema in the adult, and which he called cachexia strumipriva. In Dr. Ord's study of the disease, the relationship between myxedema in the adult, cretinoid myxedema, and cachexia strumipriva was made apparent.

The studies of Ord, Horsley, Semon, and others, have done much to advance our knowledge of the disease. The resemblance between myxedema in man, and the condition produced in animals by the removal of their thyroids was the incentive to Professor Horsley's experiments, which were almost demonstrative of the relationship between cachexia strumipriva and myxedema. Schiff and others showed that the effects of removal of the thyroid gland in animals could be modified by transplanting the thyroid glands. These observations induced Horsley to suggest transplanting thyroid glands in the bodies of man suffering from myxedema. Amelioration was produced by this procedure, but the glands were absorbed; besides the unpleasantness and possible risk in such a method. A glycerin-extract of the thyroid gland was next used on animals, after thyroidectomy, and the favorable results led Brown-Séquard to suggest that it might be useful in the myxedema of man.

Dr. Murry of Newcastle. England, appears to have been among the first, if not the first, to use the method. The difficulty in making an extract that would be stable, and the objection patients had to the hypodermic injection of the remedy, soon led to a trial, first of the cooked glands of sheep, and later to the dried and powdered gland, by Hector MacKenzie. Since this preliminary work, of which only a brief sketch is here given, many cases have been reported of this disease in man and its treatment by thyroid gland. Space will not permit a reference to the published articles and cases, and we can give but a brief reference to the interesting discussions which have arisen as to the relationship, if any exist, between myxedema and other morbid conditions, such as Graves' disease, acromegaly, etc. The object of this article is to relate. briefly the histories of a few cases of myxedema in young persons and the results of treatment with sheep's thyroids. I have invariably used the desiccated thyroid prepared by Parke, Davis & Co.; it has proved quite effective in these cases.

CASE I. In the early part of 1894 I was asked by Dr. Geo. G. Ward to see some children in a small institution in this city, of which he was then an attending physician, and I the consulting neurologist; among these children I recognized a case of cretinoid. myxedema. The child was examined by us, and the notes written

« PreviousContinue »