The thyroid gland / by Charles H. Mayo and Henry W. Plummer.

  • Charles Horace Mayo
Date:
1925
Catalogue details

Licence: Public Domain Mark

Credit: The thyroid gland / by Charles H. Mayo and Henry W. Plummer. Source: Wellcome Collection.

    82/90 page 78
    results from the administration of iodin are of short duration as many critics have indicated? If a negative answer is given, is the elevation of basal metabolism higher than it would have been if iodin were not given? Alternation of exacerbations and remissions in the course of the phenomena attributed to the abnormal product is an outstanding characteristic of the disease. A curve representing these fluctuations and another those of the basal metabolism in the average case run more or less parallel but often diverge. Not rarely, one may be high when the other approaches the base line. On the two-product theory, the heights of the curves are deter¬ mined by intensity of stimulation, free iodin supply, training and fatigue of the thyroid, as well as unknown factors. All these factors may have almost any relation¬ ships in time and degree. Tendency to parallelism in the two curves is determined largely by intensity of stimulation, and divergence by the other factors. To avoid faulty interpretation, one must conceive that the intensity of the nervous phenomena is determined by the reaction of the nervous system to the abnormal product as well as by the amount of that product, and hence can only within certain limits be used to judge the degree of intoxication. Many times crisis and death have confronted me a few hours after expressing an opinion that the patient was relatively safe. Out of a series of cases can be selected many with a course approximating the following: general in¬ crease in intensity of all phenomena into the last quar¬ ter of the first year; near crisis or crisis status; basal metabolism from +40 to +60; sudden or gradual re¬ mission followed by a rapid rise in metabolic rate to +70 or +80 without recurrence of nervous phenomena or stare. In the latter condition, the patient may be phlegmatic and obese. This picture either with high or relatively low basal metabolism is the one that sur-
    digitised image 1
    digitised image 2
    digitised image 3