Thyroidinum

Thyroidinum.

Thyroidin. Thyroid Extract. A Sarcode. Trituration of the fresh thyroid gland of sheep or calf. Attenuation of a liquid extract of the gland.

Abscess. Acromegaly. Albuminuria; of pregnancy. Amblyopia.

Amenorrhoea. A Anaemia; acute pernicious. Angina pectoris. Backache.

Chilblains. Constipation Convulsions, puerperal. Diarrhoea.

Diuresis. Dropsy. Dysmenorrhoea. Ear, middle, affections of.

Eczema. Fainting. Fibroma. Fractures, ununited.

Goître; exophthalmic. Hair, new growth of; falling off. Heart, failure of; valvular disease of. Hysteria.

Hystero-epilepsy. Ichthyosis. Idiocy. Leprosy.

Mania. Milk, deficiency of. Myxoedema. Neurasthenia.

Obesity. Oedema. Optic neuritis. Paralysis; of hands and arms.

Paraplegia. Phthisis. Pityriasis rubra. Psoriasis.

Puerperal fever. Rupia. Scleroderma. Syphilis.

Tetanus.

When the treatment of myxoedema and allied diseases by "Thyroid feeding" was introduced by Murray in 1892, many accidents occurred from overdosing. A large number of the pathogenetic effects I collected (H. W., xxix. and subsequent volumes) and arranged in Schema form (H. W., xxix. 251) along with cured symptoms, giving the authority and reference for each.

In my subjoined Schema I have omitted the references. Cured symptoms I have bracketed, unless otherwise indicated. Marc Joussett collected other symptoms in L'Art Médical, and I have added some of these, together with others from later observers. The first published case treated with an attenuation was one of my own (H.

W., xxix. 111): Eleanor N., 17, suffered from fits of "hystero-epilepsy" for ten months, following a chill. At first the fits had been frequent, latterly only before the menstrual period. The fits sometimes lasted half an hour, were preceded by swelling of limbs and face, which sometimes occurred without the subsequent fit. She bit her tongue in the fits.

Other symptoms were: pains in legs, back, and head (occiput and vertex); swelling of throat compelling her to loosen her clothes. Menses after an absence of four months returned excessively. Much left ovarian pain and tenderness. Despondent, feeble heart sounds; pulse 120; could not lie down for palpitation and headache.

Legs so weak she could not stand. Thyroid very slightly enlarged. Constipation. Sleepless, has had to take hypnotics regularly of late.

A brother of the patient was epileptic. Lach. did some good, especially improving the sleep; but no solid progress was made till Thyr. 3x, gr. ii. thrice daily, was given on November 1st. On November 4th she could lie down flat; on the 15th she could walk with assistance; on the 29th the headache had ceased; on December 6th she could walk alone quite well and the bowels acted without enema for the first time. The mental condition improved, the prominence of the eyeballs disappeared, and she left the hospital perfectly well before Christmas.

With Thyr. 1m F. C. Skinner cured a case of dysmenorrhoea in a goitrous subject. In a case of valvular heart disease following rheumatism in a man, 24, Thyr. 3x, gr. ii. thrice daily, quickly relieved a squeezing pain at the heart with inability to lie down and materially hastened the patient's recovery.

The action of Thyr. on the heart is most profound. Fatal syncope has occurred in a number of cases under "Thyroid feeding." Cyanosis was produced in many cases. Severe angina pectoris was produced by it in a patient to whom Burnett gave the 3x. The connection between the heart and the thyroid gland is very close, as seen in cases of exophthalmic goître.

Many cases of the latter affection have been cured with Thyr. In myxoedema, cachexia strumipriva, cretinism and similar conditions the thyroid gland is absent or defective, and the idea of the Thyroid feeding is to supply a physiological want. A state of puffiness and obesity may therefore be regarded as a keynote indication for Thyr. As drugs act sometimes in opposite ways, I gave Thyr. 3x gr. ii. to a living skeleton of a child aged five, and looking not more than two, who had been kept in a box in a cellar all his life till brought into hospital, when he weighted 14 1/4 pounds.

Under Bac. 200 and careful feeding he gained 1/4 pound a week. When I commenced Thyr. he put on weekly 3/4 pound, and gained the use of his legs, being able to stand by holding on to a chair. In a case of universal and very aggravated psoriasis in a schoolboy, fair, very chilly, cold, clammy hands and feet, Thyr. 3x and later 30 (which seemed to act better than the lower attenuation) completely cured after a prolonged course. An obese lady, aet. 60, developed diabetes.

I cured her completely of the diabetes with Thyr. 3x and 30. She has now for many years been able to take any kind of food. (On her husband, a spare man, who also was diabetic Thyr. had no effect.) Skin cases in great variety have been cured with Thyr. in substantial doses: Pityriasis rubra, intense redness, and scaliness of legs, and also with intense itching; ichthyosis; syphilitic eruptions; scleroderma. The nutrition of the bones is affected, and acromegaly has been relieved and united fractures made to unite.

Thyr. has increased the flow of milk in nursing women when the flow has been deficient. It has cured cases of tetany both operative and idiopathic. The keynote in these cases appears to have been "< of spasms by cold." Many cases of insanity have been cured with it, including a case of puerperal insanity with fever. H.

O. Nicholson (B. M. J., June 21, 1901) relates a case of eclampsia of pregnancy: A woman, 32, in her third pregnancy, had a fit on October 3rd.

Thyroid feeding was begun next day. Marked improvement followed. Oedema of face and body diminished. On October 23rd patient was about her usual duties.

On November 6th she was delivered of a healthy boy without any untoward symptoms. Thyr., according to Nicholson, is diuretic, like Urea; and Nicholson explains its action in eclampsia as being effected through its enabling the kidneys to carry off the toxins resulting from foetal metabolism. Thyr. is antagonistic to Adrenalin in that the latter contracts, whilst the former dilates the arterioles. Among the pathogenetic effects of Thyr., optic neuritis and accommodative asthenopia have been observed.

Some curiosities have been noted in the action of Thyr. on the growth of hair. Myxoedema patients lose their hair as a rule, and Thyr. when successful restores the growth. But in some cases the opposite effect has been noted. In one case of myxoedema the hair had fallen off the head and face and a thick growth appeared on arms and chest.

Under Thyr. the latter disappeared, and the hair on the head and face grew again (L'Art Méd., lxxxii. 44). The pains of Thyr. are stitching, aching, or heavy pains, and tingling sensations. At the point of injection when administered subcutaneously brawny swelling occurred in one case (which may suggest scleroderma) followed by abscess of slow development. Persons suffering from skin diseases were found tolerant of much larger doses than myxoedemics.

In a number of cases latent phthisis has been lighted up into activity. Syphilis, both secondary and tertiary, has been vastly relieved by Thyr. Hansen mentions fibroma uteri as having been cured by Thyr., and Burford supports this. "Brawny swelling" is a keynote of Thyr. pointed out by Burnett.

With Thyr. 3x gr. vi. thrice daily he cured a case of dropsy and albuminuria which had been given up by several doctors. Burnett noticed that the swelling was brawny. Soon after commencing Thyr. the patient passed a quantity of fluid from the feet and got quite well. The symptoms are: > By rest.

< By least exertion; by stooping. (Heart was < lying down.) < By cold. (Thyr. treatment nearly always raises the bodily heat.)

Compare: Myxoedema; psoriasis, &c., Ars. [I permanently cured a case of myxoedema with Ars. high, before the Thyroid method was introduced (H. W., xxvii. 443); arsenic has been found to be a normal constituent of the healthy thyroid gland]. Phthisis, Bac. [I have found Thyr. follow Bac. well. Greenfield (see H.

W., xxix. 7) found tuberculosis very common in myxoedemics, in five out of seven fatal cases it was widespread and advanced; he also found it in one case of sporadic cretinism. Young, of Switzerland, has cured cretinism with Bac.] Syphilis, Merc., K. iod., Syph. Goître, exophthalmic, Spo., Iod., Spi. Diuresis, Urea.

Optic neuritis, Tab., Carb. s. Dilated arterioles (Adren., opp.). Ununited fractures, Symph. Wakes with headache, Lach, Follows well: Lach., Bac.

Moist patches behind ears heal up (case of psoriasis).—Hyperplasic median otitis with sclerosis and loss of mobility of the ossicles (rapid amelioration—several cases).

Flatulence increased, followed later in the case by amelioration.—Headache and pain in abdomen.

Slight attack of haemoptysis, followed by cough and signs of phthisis at apex of l. lung.—(Voice became clear.).—Dormant phthisis; lighted up the disease in five cases.

Malaise > by lying in bed Stooping = palpitation Rest in recumbent position > extreme breathlessness with lividity, felt as if dying Myxoedematous patients are always chilly; the effect of the treatment is to make them less so

Loss of consciousness and general tonic muscular spasm for a few seconds Fainting attacks (many cases) Tremors, quivering of limbs, complete unconsciousness.—(Tetany.) Epileptiform fit, after which he was unconscious for an hour; next day felt better and warmer

Malaise so great she refused to continue the treatment Agitation Incomplete paraplegia Hysterical attack.—(Hystero-epilepsy with amenorrhoea.)

Nervous and hysterical, had to have nurses to watch her Feels tired and sick Stabbing pains Aching pains (many cases)

Aching pains all over Diffused pains Aching pains in various parts of body Pains over whole body

Brawny swelling at point of injection, followed by abscess of slow development Myxoedema removed (many cases).—"A series of abscesses resulting from the injections, but probably originating from an accidental abscess quite independent of them." A small abscess formed Increased suppuration in case of lupus

Gained a stone in weight Lost weight enormously (many cases of myxoedema) Rapid gain of flesh and strength Anaemia and debility

Infiltration rapidly absorbed (psoriasis) Persons suffering from skin disease can bear much larger doses than those suffering from myxoedema.—(Acromegaly, headaches, and subjective symptoms.).—(Fractures refuse to unite.) A peculiar cachexia more dangerous than myxoedema itself Syphilis secondary and tertiary.