The administration of thymus in exophthalmic goitre / by R.H. Cunningham.

  • Cunningham, R.H.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: The administration of thymus in exophthalmic goitre / by R.H. Cunningham. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    5/6 (page 745)
    disease are applied. But whether the alteration of these glands, for instance of the thymus, is primary, concomitant, or secondary to a primary derangement of the nervous system (Marie), or to a toxic blood state induced by the functionally altered thyroid (Moebius), or by various “ toxins ” of gastro-intestinal origin, are questions which possibly may be explicitly answered in the future when a more definite knowledge of all of the functions and of the effects of disordered function of the individual ductless glands has been obtained from clinical observation and from further experi- mental investigation. 59 West Sixty-fifth Street. References. 1 David Owen : Further Notes on the Treatment of a Case of Ex- ophthalmic Goitre. British Medical Journal, February 16, 1895. 2 Gowers : Diseases of the Nervous System, vol. ii., pp. 871-894. 3 Gauthier : Des Goitres exophthalmiques secondaires ou symtoma- tiques, Lyon Med., xxv., Janv., 1893. 4 Moebius : Ueber die Basedow'sche Krankheit, Deutsch. Zeit. f. Nervenheilkunde, 1891 (1, 5, 6) Also numerous references in Schmidt's Jahrbucher. 5 Halliburton: Text-book of Chemical Physiology and Pathology, 1891. 6 Kossel: Ueber die Lymphzellen, Deut. med. Woch., xx.,7, 1894. 7 Goulay : The Proteids of the Thyroid and the Spleen, Journal of Physiology, xvi., 1 and 2. 1894. 6 Langenhaus and Saveliew: Beitr.ige zur Physiol, d. Brustdruse, Arch. f. Path. Anat., cxxxiv., p. 344. 9 Charles Macalister : Clinical Lecture on the Inhibitive Functions of Glandular Secretions on some Chronic Diseases, British Medical Journal, April 8, 1893. 10 Byrom Bramwell: The Clinical Features of Myxcedema, Edin- burgh Medical Journal, May, 1893, p. 985. Acromegaly in a Giantess, British Medical Journal, January 6, 1894 11 Hanfield Jones : The Thymus, in Cyclopaedia of Anatomy and Physiology (Todd), 1849-1852, p. 1,087. 12 Fuhr : Die Extirpation der Schilddriise, Arch. f. Exp. Path., Bd. xxi. 43 Lemke: Ueber Diagnose u. Theorie des Morb. Basedowii, Deutsch. med. Woch., xx., 1894, p. 953. 14 Zanda : Sur le Rapport fonctionnel entre le Rate et la Thyroi'de, Arch. Ital. de Biol., xix., p. 432. (Ref. in Hermann's Jahresbericht u. d. Fortschritte d. Physiol., 1895 ) 45 Fano : Sulla Funzione e sui Rapporte funzional del Corpo Ti- roide, Rio Clinico, 1893 16 Rogowitsch: Zeigler's Reitrage, Band iv. ; and Archives de Physiol., 188B. 17 Boyce and Beadles : Enlargement of the Hypophysis Cerebri in Myxoedema, Journal of Pathology and Bacteriology, October, 1892. A Further Contribution, etc., Journal of Pathology and Bacteriology, February, 1893. 16 P. Marie : Sur la Reviviscence du Thymus dans certain Affections presentent des Alterations du Corps Thyroi'de ou de quelque autre Glande vasculaire sanguine, Bui. et Mem. Soc. Med. d. Hop. de Paris, 1893, p. 136. Sur la Nature de la Maladie de Basedow, Bui. et Mem. des. Hop. d. Paris, 1894, p. 132. 19 Kocher : Corr. Bl. f. Schweizer Aerzte. xxvi., 1895. 20 Putnam : Exophthalmic Goitre and Thyroidectomy, Journal of Nervous and Mental Diseases, xix , p. 359, 1894. Pathology and Treatment in Graves's Disease, Brain, 1894. 21 Booth: Journal of Nervous and Mental Diseases, xxi., August, 1894. 22 Brissattd : Maladie de Basedow, Lefons sur les Maladies ner- veuses. 23 Beclere : Un Nouveau Cas de Myxoedeme gueri par l'Alimenta- tion thyroidi'enne, Mercredi Med., October 17, 1894, p. 511. 21 Ballet and Enriques : Goitre experimental par Injections sous- cutanees de Liquide tbyroidien, Sem. Med., xiv., 1894, p. 536. Nou- veau Cas de Goitre, etc., Soc. Med. d. Hop. d. Par., 1894, p 941. 25 Horsley : Remarks on the Function of the Thyroid Gland, British Medical Journal January and February, 1892. 25 Voisin ; Maladie de Basedow ameliorfe par 1'ingestion de glande Thyroi'de, Sem. Med., xiv., 1894, p. 472. 27 Jeanselme : Coexistence du Goitre exophthalmique et de la Scle- rodermie, Revue Neurol, ii., 1894. (Ref., Schmidt's Jahrbuch, 1895 ) 26 Souza-Leite : De l'Acromegalie, 1890. 29 Cross : A Case of Lymphadenoma Accompanied by Features Characteristic of Myxoedema, and Others Suggestive of Acromegaly, New York Medical Record, 1894, p. 269. 30 Williams : Graves's Disease and Myxcedema, British Medical Journal. April 15, 1893. 31 Murray : Thyroid Secretion as a Factor in Exophthalmic Goitre, Lancet, November 11, 1893. 34 Goldscheider : Zur Gewebssafttherapie, Deut. med. Woch., xx., 1894. 33 Dreschfeld : A Case of Acromegaly, British Medical Journal, January 6, 1894. 34 Reymond: Goitre exophthalmique, Bui. de la Soc. Anat. de Paris, 1893, p. 456. 35 Parsons : Report of a Case of Acromegaly, Journal of Nervous and Mental Diseases, xxi., 1894, p. 717. 3,1 Thompson: Ref. Revue des Scien. Med., April 14, 1894. 37 Beard: Anat. Anzeiger, ix., 1893-94, p. 476. 38 Cadeac : Compt Rendu de la Soc. de Biol., 1894, p 508. 38 Sonnenberg : Acutes operatives Myxdedem behandelt mit Schild- drusen-fiitterung, Arch. f. Klin. Chir., xlviii., 4, p 857. REPORT OF AN EXPERIENCE WITH ANTI- TOXIN AT THE NURSERY AND CHILD’S HOSPITAL.1 By ALLEN M. THOMAS, M.D., ATTENDING PHYSICIAN, NURSERY AND CHILD’S HOSPITAL, NEW YORK. Since the date of an epidemic of diphtheria in the hospital in the fall of 1893, there has been from time to time an occasional outbreak in the wards. In January of this year, with the aid of fresh invoices from without, another epidemic was started associated with more or less of measles and broncho-pneumonia. These con- ditions so complicate the histories, and a close personal knowledge of the cases being impossible on account of my obstetrical obligations, I regretfully refrain from any attempt at reporting them. Dr. J. J. Mapes, the house physician, who has given to all this work his intelligent and close personal attention, may be able to do so at some future time. The following report is consequently limited to an account of the antitoxin immunization in regard to which the facts at hand came under my personal obser- vation, are uncomplicated, and surely simple enough to be beyond the likelihood of misstatement or miscon- struction. I present them without further comment as follows : Total number of cases in the hospital from January 18th, the time of outbreak, to April 18th, the date of im- munizing, 46. In all these cases cultures of the Klebs- Loeffler bacilli were obtained, and observations of them doubly verified in most cases by the separate examina- tions of the Board of Health and Dr. Mapes. In 30 of these 46 cases abundant local clinical aspects existed, there being well-marked pseudo-membrane in the throat, nose, or larynx ; the remaining 16 cases had only sero-purulent or sero-sanious nasal discharges as a local manifestation. Of the entire number of 46 cases 15 occurred between April 1st and April 18th, and 7 between April nth and April 18th, plainly show- ing the epidemic to be gradually on the increase in the hospital up to the day of immunizing. On April 18th 30,000 units of antitoxin were obtained from the Board of Health, and no children immunized. On April 20th 26 more children were immunized, and the 32 re- maining children in the hospital that had previously had throat or nose lesions containing Klebs-Loeffler bacilli were not immunized. Of these cases immu- nized the following table shows the age, number, and antitoxin units : Age. Number. Antitoxin Units. 3 to 4 weeks 7 50 2 months 50 to 75 3 to 6 months 36 IOO 7 months to 1 year. . . . 22 150 2 to 4 years 59 200 Careful examinations were made individually for albumin, variations of temperature, and skin lesions, in connection with the general observation of the children as a whole. A few (4) showed faint traces of albumin in the urine, but this in no case (where the urine could be regularly obtained) persisted more than three to four days, nor was there in any case any rational symp- toms pointing to any special disturbance of the kid- neys. Three cases, eight days after the injections, and 4 cases, nine days after the injections, had an eruption, more or less profuse, of erythematous patches of the size of a silver dollar, in some isolated, in others running together about the head, trunk, and extremities ; but in no case were they associated with any appreciable fever ; in this respect markedly differing from cases that have been reported of erythematous eruptions occurring with rather startling elevations of temperature. Red, pea-sized, shotty papules appeared rather profusely on the face, in one case on the eighth day, and in another on the ninth, and the same kind of papules appeared on the face and both arms in a third case, also on the 1 Read at a meeting of the New York Clinical Society.