Acromegaly : an essay to which was awarded the Boylston Prize of Harvard University for the year 1898 / by Guy Hinsdale.

  • Hinsdale, Guy.
Date:
[1898?]
Catalogue details

Licence: Public Domain Mark

Credit: Acromegaly : an essay to which was awarded the Boylston Prize of Harvard University for the year 1898 / by Guy Hinsdale. Source: Wellcome Collection.

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    Cases have been treated with thyroid extracts by the following authors: Bramwell, Benson, Sanger Brown, Bruns, S. Solis-Cohen, Costanzo, Eschle, Eshner, Jeffrey, Mendel, Mosse, Middleton, Mur- ray, R. N. Parsons, J. J. Putnam, Schultze, Unna and Vinke, Sears, Comini, Witmer. Bruns' patient was a woman, aged 24, who, after an abortion in her first pregnancy, experienced vague pains and forms of pares- thesia in the hands and feet, which were noticed to become gradually enlarged. Two years later she presented a typical picture of acro- megaly, with enlargement of bones and soft parts of the face; marked thickening of bones of trunk, especially the clavicles; hands and feet enormously enlarged; patient extremely nervous and excitable, sleeping very badly; suffering from almost constant head- ache; vague pains and abnormal sensations in extremities, prevent- ing her from doing any fine work. Tabloids of thyroid extract (quantity unknown) were given in increasing doses until four were taken per diem. The enlargement of parts persisted, but the improvement in subjective symptoms was striking; the nervous excitability rapidly diminished, the patient slept well, and the headache disappeared; the pains in the extremities also vanished, and the patient was able to resume the finest work. Benson's and Mosse's cases treated with thyroid extract also gave good results. In the latter the chief benefit was observed in the mental symptoms. The patient afterwards died, and a large sarcoma of the hypophysis, weighing thirty-six grammes, was found. In a case recorded by J. J. Putnam, thyroid powder in doses of fifteen grains every second day made great improvement. The hands and feet diminished steadily in size, so that the patient (a woman) at the end of three weeks was able to resume work with her hands, and after further treatment could wear boots that she could not get on at all when her symptoms were at their height. In Feliciano Costanzo's case remarkable improvement followed the use of the thyroid extract for a period of eighty-one days, including a cessation of two weeks on account of physiological symptoms due to the drug (pulse 140, vomiting, temperature 39-400 C, pain in the head and limbs). The dose was three teaspoonfuls administered by the mouth three times a day. Before After treatment. treatment. ,. 7.5 cm. 7 cm. . 7.5 cm. 7 cm. .. 7.5 cm. 5 cm. ,. 6.2 cm. 6 cm. Right hand—Circumference of thumb. Circumference of index finger— First phalanx Second phalanx Third phalanx