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Experimental removal of the pituitary was essayed by Horsley in 1886, the same man who two years before had reproduced myxedema successfully in monkeys. Others succeeded his attempt. But the conclusions drawn were uncertain or contradictory, resulting from the difficulties of the operative technique of getting at a gland placed at the base of the brain.
A crystallization of ideas about the true function of the thyroid was now inevitable. In 1884, Sir Victor Horsley produced an experimental myxedema by removal of the thyroid in monkeys, resembling closely in its symptom-picture the disease as it occurs in human beings.
Also a train of symptoms similar to those evoked by an oversecretion of the thyroid may be mobilized by the taking of too much iodine. Great sorrow, great joy, a sudden severe jolt to the nervous equilibrium, sexual excitement, an overwhelming anger or grief may leave in their wake a permanent hyperthyroidism. The symptoms are the reverse of cretinism and myxedema.
At seventeen months the child presented the typical appearance of a sporadic cretin. The astonishing results of six months' treatment with thyroid extract are shown in the second figure. After a year's treatment the child presents the appearance of a healthy and well-nourished little girl. Myxedema proper is a constitutional condition due to the loss of the function of the thyroid gland.
This is in agreement with the experimental findings that anesthetics, curare, or any break in the muscle-brain connection causes diminished muscular and heat production. The Thyroid. In myxedema one of the cardinal symptoms is a persistently subnormal temperature and, though prone to infection, subjects of myxedema show but feeble febrile response and readily succumb.
The symptoms of myxedema, as given by Ord, are marked increase in the general bulk of the body, a firm, inelastic swelling of the skin, which does not pit on pressure; dryness and roughness which tend, with swelling, to obliterate the lines of expression in the face; imperfect nutrition of the hair; local tumefaction of the skin and subcutaneous tissues, particularly in the supraclavicular region.
Then Sir William Gull in 1873 painted the singular details of a cretinous condition developing in adult women, a condition to which another Englishman, William Ord, of London, five years later donated the title of myxedema, because of a characteristic thickening and infiltration of the skin that is one of its features. Surgery then enters upon the scene. The great Swiss surgeon.
All these are grades of the degeneration which Ord, the Englishman, named myxedema. At its worst it is a sort of bloating and drying of the body and the mind. Then there is infantilism, which is helped by the giving of thyroid extract.
Thyroid deficiency in children gives rise to a form of idiocy, bodily malformation and degeneracy known as cretinism, while in adult life it is associated with a similar disorder known as myxedema.
Recently, Leichtenstein, observing in a case of myxedema treated with the thyroid gland that the subcutaneous fat disappeared with the continuance of the treatment, was led to adopt this treatment for obesity itself and reports striking results.
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