Affections of the Ductless Glands

Affections of the Ductless Glands


Every gland depends upon the cooperation of the others. “Bear ye one another’s burdens,” is an admonition that has been obeyed by the organs of the body since the beginning of life. We learn of complications in the interrelations of the glands themselves and of the glands and other parts of the body, wherefore, it should be obvious that only a general integrity will avail. Glands are only organs, like the muscles, or the stomach. They have no existence, as such, in nature. They exist only in relation to other parts, or rather, in relation to the whole organism. No doubt the whole endocrine system is an organic unit, as is often asserted, but it is no less so than the body and all of its parts. The glandular system is a unit only in relation to the whole body, apart from which it has no existence. The body functions as an organized unit and not as a mere collection of organs. We cannot separate organs from their reciprocal relations. To rely upon interference with glands and hormones and their relations is to rely upon things concerning which we have merely fragmentary knowledge. We should rely rather upon preserving (or restoring) intact, our integrity. We deal with an organism and its ways of life, not merely with theoretically isolated parts of the organism.
All the glands of the body, be they ducted or ductless, are under the constitutional or federal government under the union of the organism (symbiosis). Whatever amount of individual control or individuality the various organs may have, all are bound together by the blood and nervous system. The fact that the sympathetic nervous system regulates the nutrition and functioning of the tissues and the secretion of hormones, makes difficult the understanding of hormones.
We forget that the conservation of life energy is in our own hands and not in the hands of some clever medical profession which will yet discover the right chemicals with which to treat the glands. We control our metabolism ourselves: the glands being parts of us, take part in the control. We ignore, too, the fact that “the crowded foulness of our body” is due to “rioting joys that fringe the sad pathways of Hell.” The oft’heard statement, “It’s my glands, doctor,” is based on the thought that the glands may go wrong without cause, that glandular malfunction is responsible, for our troubles, instead of us being responsible for the glandular malfunction. “Science” investigates everything except the fact that evolution is determined by nutrition.
Unfortunately as in everything else, instead of trying to understand these glandular functions and instead of searching for the natural conditions upon which normal glandular function depends, the search has been directed to finding substitutes for normal functions.
All the organs of the body, the ductless glands included, are weakened and various affections develop, as their secretions and excretions are molested by continued toxemia and pan-toxemia
Certain, if not all, of the glands are involved in the body’s defense against poisons. The supra-renal cortex and the thyroid gland are especially involved in the toxin defense. The glands react to any intoxication by increased functioning.
Chronic irritation, resulting from chronic protein poisoning, will result in chronic hyperfunctioning of the glands until exhaustion results in hypofunction. Hyperfunctioning may lead to enlargement and consequent change of structure in the gland. Or, a degeneration of the gland’s active elements may result, so that often, as a result of “a slight infection of short duration,” the organism is permanently thrown out of balance.
The chief cause of intoxication (infection) is protein poisoning, such as that connected with the pernicious habit of meat and egg eating. Man’s life and feeding habits are so contrary to the best interests of his body that the ensuing poisoning requires to be specially coped with and provided against by particular glands, the task of which is a very delicate and arduous one, involving frequent fatigue and breakdowns due to overwork, making the task increasingly difficult.
Glands function efficiently or not depending on their nerve and food supply. If the blood is normal, their supply of food is normal; if the nervous system is normal, they are properly energized. With pure blood and normal nerve force, gland function will be normal. These depend upon our conduct our mode of living.
What causes a gland to function? Nerve energy. No doubt inter-glandular reciprocity exists, but over all is a nervous system that furnishes energy for the work. Full nerve energy spells good function. When nerve energy is lowered, functions lag. Glandular function cannot be normal in an enervated body. Glandular malfunctioning is an effect, not a cause. However, “modern medicine” always starts with an established pathology as cause.
The tendency today is to class almost all symptoms as symptoms of endocrine gland ‘disease”; to attribute practically all human defects to endocrine disorders. Nowhere is it realized that the endocrine disorder and the defects elsewhere are due to common causes.
We do not intend to deny that malfunctioning of these glands adds to the pathology. We do insist that the glandular dysfunction is not the primary cause and that any program of care that neglects the primary cause cannot produce satisfactory results. Such a program is merely a system of palliation or patchwork.
The regular approach to glandular malfunctioning either remove the glands in whole or in part, or resorts to the use of gland extracts. It is customary to indict the organ and ignore the causes of its malfunction. The poet has well summed up this procedure in these lines:

“And wouldst thou play Creator
and Ordainer of things,
Be Nature then thy chaos and
be thou her God.”

Removing the glands deprives the body of their functions and, in the case of certain glands, means speedy death. In the case of all of them it means much additional trouble. The evils following the removal of the ovaries are generally known. Whether the whole gland is removed or merely part of it, this does not touch the cause of the trouble. If part of an enlarged thyroid is removed the remaining portion enlarges, due to the persistence of the cause of the original enlargement, and another operation is deemed necessary. Two and three operations upon the thyroid are not uncommon.
There is probably the same need for a slow uniform delivery of all the internal secretions as there is for that of the adrenal glands. At the same time, there is evident an increased or decreased delivery as need occasions. It is impossible to adjust external administration of hormones to the varying needs of the body.
Foreign hormones do not behave like domestic productions and their use is often responsible for serious injury, even death. The result of an “overdose” of insulin is now common knowledge. The evil results of an “overdose,” or of the continuous use, of adrenalin and of certain ovarin secretions are also well known.
That the use of gland extracts does not remove cause should be apparent to the least discerning. That this form of treatment is highly unsatisfactory is everywhere admitted.
Still another objection to the use of glandular extracts is the fact that after these have been employed for a time, the body seems to learn to destroy them. It seems not to use them. The endocrinologists have reckoned without the body’s resistance to assaults upon its glandular equilibrium. It was demonstrated by Prof. J. B. Collip and his associates, of McGill University, that when foreign-gland substances are injected into the body the body manufactures “anti-hormones.”
“The result is that, after a time, the effect of new injections is neutralized, and the glandular balance of the body becomes about as it was in the beginning.”
Physicians have been puzzled by the fact that glandular cases not only fail to improve under glandular treatment, but become worse. The reason seems to be that the effect of the treatment is nullified by the generation of “anti-hormones,” with the result that the patient is worse off than before.
Sokoloff admits that the diagnosis and treatment of separate glands fail to yield satisfactory results. He adds: “What most frequently takes place is merely further disturbance of the endocrine gland system.”
When an organ is overworked, enervation follows. Through failing cooperation or reciprocity all the organs are hindered in their functions of assimilation, secretion and excretion. When an enervated gland fails to function a reasonable remedy would be to find the cause of enervation and remove it. When an overstimulated (irritated by toxins) gland functions too much, a logical remedy would be to find the cause of the over-stimulation (irritation) and remove it.
No amount of spectacular stimulation or inhibition of the overburdened glands can be depended on to adequately deal with the poisoning. Only a complete revolution of the mode of living can take the intolerable burden of toxins off the glands and permit a return of normal gland function. Treating the adrenal cortex, for instance, with the intent of increasing its toxin-fighting power is ridiculous when we have it in our own hands, by a wise choice of food, or by temporary abstinence from food, to avert poisoning.
Stimulating and inhibiting overworked glands enervates them still more. No wonder then that, as Sokoloff says, treating separate glands frequently causes “further disturbances of the endocrine gland system.”
Knowing that the glands are integral part of an interdependent organism and not the creators of that organism, it should not surprise us to learn that the ductless glands share in the general malnutrition of the body in the so-called deficiency “diseases.” Nearly all of them undergo atrophy. Under certain conditions, attributed to a lack of vitamin B, the adrenals undergo hypertrophy.
In polyneuritis, all the glands, except the, adrenals and the pituitary body, undergo gradual atrophy, and these undergo hypertrophy. The occurrence of atrophy is in about the following order: testicles, spleen, ovaries, pancreas, heart, liver, kidneys, stomach, thyroid and brain. The parenchymatous tissues (the vital or functioning tissues) of the glands gradually disappear, and are replaced by functionless connective, or scar, tissue. The spermatozoa disappear from the testicles, while the secretion of saliva, gastric juice, bile, intestinal juice and pancreatic juice declines.
These changes are regarded as results of lack of vitamins and it is asserted that when vitamins are supplied the glands begin to secrete and the atrophic changes gradually disappear. The testicles of young animals, even though they have degenerated so much that their active cells have almost entirely disappeared, return to normal and again produce spermatozoa. The digestive secretions reappear and appetite returns with renewed force.
The adrenal glands are made up of two portions each of which secretes a different substance — the medullary portion, which secretes adrenalin, and the cortical section, which secretes cholin. These two substances are supposed to “antagonize” each other In maintaining blood pressure. In polyneuritis the hypertrophy of the adrenals affects chiefly the medulla, whereas the cortex tends to atrophy.
In pellagra the adrenals are markedly atrophied, the degeneration being especially noticeable in the medulla. These glands may be reduced to one-tenth their normal size. Degeneration is also seen in the islands of Langerhan’s of the spleen, in this condition.
In scurvy there is marked glandular atrophy, especially of the digestive glands. The arrest of the digestive secretions is so great that in the severer cases there is complete achylia (absence of chyle, a milky fluid found in the mesenteric vessels during absorption), and a great reduction in salivary secretion, the saliva being, usually, strongly acid in reaction.
A long-continued deficiency of the amino-acid, tryptophan, in the diet causes a degeneration of the endocrine glands. In osteomalacia, there are frequent signs of endocrine disorder, such as amenorrhea in women, and failure of menstruation to begin in. girls at puberty. In malnutrition the milk glands fail and these may even undergo atrophy. The reduction of the secretion of the glands is consequent upon the malnutrition and also upon their atrophy.
In discussing the conditions of growth, Berg says: “As far as the widespread atrophy of the organs is concerned, the main cause of this is doubtless the general failure of nutrition consequent on, the digestive disturbances. But when there is defective nutrition because the diet is quantitatively inadequate though qualitatively adequate, we find general atrophy differing from that characteristic of the deficiency diseases in that the glands continue to function. In the acomplettinoses (vitamin deficiencies), on the other hand, impairment of glandular functioning makes itself apparent at a very early stage. We have seen that this is especially characteristic of a lack of vitamin, of B, and of D.”
The knowledge that the glands undergo more or less complete regeneration when proper nutrition is again supplied them is especially important. Such knowledge is particularly valuable in diabetes, where the diet usually prescribed, intended only to secure the disappearance of sugar from the urine, succeeds in this object, but at the expense of the body and the pancreas. The diet adds to the primary pathology in producing a temporary abatement of one of the symptoms. What is needed in this, as in other glandular atrophies, is a regeneration diet, or one at least that will aid in restoring normal function to the remaining functioning tissue in the pancreas. The diets at present prescribed in this condition not only do not aid the restoration of function, but actually add to the functional as well as the structural impairment.
Uncooked fruits and vegetables are the gland “remedies” par excellence. These contain the complettins and minerals so necessary to regeneration of gland structure and of other structures in the body.
In such conditions as diabetes, Bright’s “disease” and heart “disease,” tissue regeneration and the re-establishment of functional efficiency are the prime requisites. The chief object in a case of diabetes, for instance, should be the re-establishment of healthy pancreatic function and not merely the disappearance of sugar from the urine. Sugar in the urine is a symptom which, unfortunately, may be controlled by a diet which will at the same time, make the condition of the pancreas (which is the primary pathology), actually worse.
A process of regeneration, which will include a regenerative diet, will also cause the sugar to disappear from the urine, but it will, at the same time, bring about an improvement in the pancreas. The disappearance of glycosuria should be only incidental to the arrest of the primary pathology and the regeneration of the pancreas.
Cure depends upon the amount of functioning tissue that remains in the pancreas. As only a small amount is required to meet the usual demands of life, once that amount has been restored to health and the patient is taught to eat and live within his capacity, he may enjoy a long and useful life.
So, also, in Bright’s “disease” — the disappearance of albumen from the urine is merely incidental to the arrest of the degenerative or destructive process in the kidneys. A regenerative diet coupled with other regenerative influences and not the conventional symptomatic treatment is required.
Below we shall take up the glands in alphabetical order and discuss their affections in alphabetical sequence.

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AFFECTIONS OF THE ADRENALS

ADDISON’S “DISEASE”

Definition: A rare symptom-complex “due to inadequacy of the adrenal glands,” and characterized by extreme muscular weakness, weakness of the heart and blood vessels, bronzing of the skin and mucous membranes, and irritability of the gastro-intestinal tract.

Symptoms: Profound muscular weakness, said to develop “without obvious cause” and unaccompanied with corresponding emaciation, develops early. Blood pressure is very low and in advanced cases fainting frequently occurs. Brownish pigmentation (bronzing of the skin) which is almost universal, but is especially marked on the exposed parts and genitalia, around the nipples and navel, and wherever the skin has been irritated or compressed, appears sooner or later in almost all cases. In many cases the mucous membranes are also pigmented. Gastro-intestinal irritability, evidenced by pain and discomfort in the stomach region, loss of appetite, recurrent vomiting or diarrhea, is common. The usual changes of secondary anemia are seen in the blood. There is decided hypofunction of the supra-renal glands.

Etiology: To attribute this symptom-complex to hypofunction of the adrenal glands and stop there is not to find cause. To record that it is more common in males than in females and that it develops most often between the ages of twenty and fifty years, does not reveal cause. There must be a cause for the pathology in the adrenal glands and the poverty of their enzymes. That “the causes of tuberculosis in general favor its development” and that “tuberculosis of the adrenals is the common anatomical change” points to toxemia, intestinal sepsis and dietary deficiency as cause.

Prognosis: “The disease is probably always fatal, and, usually lasts from a few months to several years. The course is not uniform but marked by remissions and exacerbations.” This is the medical prognosis. Weger says: “The duration of the disease varies from a few months to two years and rarely is a recovery recorded. The few cases that have come under our observation and care have undoubtedly had their lives prolonged by correct living.”

Care of the Patient: The first thing to be done in all cases is to relieve the body of its toxic overload and restore nerve energy through fasting and rest. All enervating practices must be discontinued and a general program of health building carried out. Proper feeding will always include abundant quantities of fresh fruits and green vegetables. Meat and eggs should be abstained from.
The hypofunctioning of the adrenal glands is not due to a lack of their secretions and no cure can be reasonably hoped for from the use of adrenal extracts. The physiologist, P. G. Styles, says of the adrenal glands: “Their extracts do not successfully compensate for the lack of living cells; the body seems to need a slow uniform delivery of this internal secretion, and periodic dosing does not prove equivalent to the natural condition.”

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AFFECTIONS OF THE PARATHYROIDS

TETANY

Definition: This is a rare affection characterized by bilateral tonic, intermittent or continuous, spasms, especially of the extremities, and increased irritability of the nerves and muscles, especially in. response to mechanical and electrical stimulation.

Symptoms: Tonic spasms beginning in the hands and feet, on both sides, and spreading upward, come on apparently suddenly. The muscles of the face and trunk are rarely involved. Indeed in some cases the hands alone are affected. The spasms usually come on paroxysmally and last from a few minutes to an hour or two; though in very severe cases they may be more or less continuous. Pain sometimes accompanies the spasms. In children laryngismus stridulus is common. Slight fever and edema occasionally accompany the cramps.

Latent tetany which presents very mild spasms may consist of muscular irritability, slight stiffness without spasm and morbid sensations.

Etiology: Parathyroid insufficiency resulting in a lack of calcium in the blood is the standard cause. It develops after removal or destruction of the parathyroid glands. It is seen in certain types of poisoning (ergot, chloroform, etc.) and in handworkers (shoemakers, tailors, etc.) who come in contact with poisons. It sometimes develops in pregnancy, perhaps due to the robbery of the maternal blood of calcium by the embryo and in lactation, probably from the same cause. It sometimes appears in “acute infections,” and in adults is seen most commonly as a complication of gastrectasis. Poisoning and deficiency seem to be the chief causes of non-operative cases.

Prognosis: Cases last from a few days to several months and relapses are common. The spasms may occur at intervals of hours or days. The general outlook is good. A high mortality is noted in tetany arising in gastrectasis. Removal of toxemia, better food and a re-ordered life will modify the above.

Care of the Patient: Certainly no food should be given during the spasm, nor thereafter until toxemia is removed. All enervating practices should be discontinued and all sources of poisoning removed. A diet of fresh fruits and green vegetables will supply the body with all the calcium and other elements needed. Nothing is gained by feeding lime-rich foods so long as the parathyroids are impaired.

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AFFECTIONS OF THE PITUITARY

ACROMEGALY

Definition: A perverted development of the body characterized by overgrowth, especially of the hands, feet, and face, and seen in adults.

Symptoms: The most outstanding symptom is gradual enlargement of the hands, feet and face. The face is elongated, the nose large and bulbous, the Lower jaw massive and prominent (prognathism), and the lips and tongue are thick. Sausage-like fingers stick out from large, spade-like hands, and the feet are similarly affected. There is almost always kyphosis. Very early in its development the male becomes impotent and the female ceases to menstruate. Muscular weakness, excessive thirst, sugar in the urine and mental dullness are frequently noted in advanced cases. Headache and defects of sight (hemianopsia) and other evidences of gross intracerebral “diseases,” often develop.

Complications: Affections of the heart and arteries, diabetes, myxedema, and exophthalmic goitre are common associations.

Etiology: This condition is commonly attributed to overactivity of the anterior lobe of the pituitary gland. The overactivity remains to be accounted for. It is probably the same as the cause of overstimulation of all the other organs of the body.

Care of the Patient: Surgery and gland extracts have failed. Removing the general causes of pathology may be valuable. We have had no opportunity to try it.

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GIANTISM

Definition: This is abnormal overgrowth of the whole body or of part of it. It is attributed to excessive secretion by the anterior lobe of the pituitary gland in the young. Giantism and acromegaly are similar conditions We know of no cases that were ever cared for by hygienic means but it is our opinion that toxemia is the most likely cause of the pituitary hyperfunction and that when this is neglected the most forward-looking care for one so troubled is overlooked.

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HYPOPITUITARISM

Definition: A symptom-complex characterized by general obesity, atrophy or failure of development of the sexual organs, a lack of pubic hair, sleepiness, and high tolerance for carbohydrates.
Four other closely related conditions are included under the above general head as follow:

Adiposis Dolorosa (Dercum’s “disease”): More or less symmetrical deposits of fatty masses in various parts of the body, attended or preceded by pain and frequently associated with loss of strength and mental abnormalities characterize this form.

Ateliosis: A childish facial appearance, diminutive stature, with short, slender limbs, ill-developed muscular prominences, small jaw bones, a thin piping voice, low blood pressure and scanty urination, characterize this condition.

Idiopathic Infantilism (Lorain type): This is a condition in which the characters of childhood persist in adult life. Several forms are described but the distinctions are unimportant. The sex organs are wasted or fail to develop, the secondary sexual characteristics (beard, broad shoulders, change of voice, etc., in males; breasts, broad hips, etc., in females) never develop. The face remains infantile.
The pubic region is devoid of hair. Often, but not always, there is dwarfness of stature. Marked mental retardation is usual, but, rarely, these individuals are quite bright but likely to be eccentric, egotistical, even egomaniacal.

Progeria: This is a form of infantilism associated with premature senility and hardening of the heart and arteries.

Etiology: These conditions are thought to be due to insufficiency of the pituitary gland, though it is conceded that other glands of internal secretion may also be concerned in the process. Certain, it is, that many of these failures of development follow early removal of the gonads (ovaries and testicles) and there is atrophy or failure of gonadal development in all of these cases.
What causes the pituitary hypofunction? What causes the gonadal failure? What causes the gonadal atrophy? Here must be metabolic perversion, beginning, perhaps, in the mother. Poisoning and the resulting deficiencies must be considered as cause.

Care of the Patient: Perhaps something can be done for these cases if the condition is recognized early and nutrition corrected. Proper food and sunbaths should help. Certainly nothing will be of value after development is far advanced. As the condition is not due to lack of secretion, to supply glandular secretions from without will not normalize the faulty glands.

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AFFECTIONS OF THE SPLEEN

GAUCHER’S “DISEASE”

Definition: Gaudier, after whom the condition gets its name, described it as “primary epithelioma (cancerous growth of the epithelial tissues) of the spleen,” but it is thought to be identical with splenic anemia. Certain it is that it is difficult, if not impossible, to distinguish it from Banti’s “disease.”

Symptoms: It is seen largely in children, and develops slowly. Because of the enlargement of the spleen there is progressive enlargement of the abdomen which is more noticeable on the left side. This added bulk causes much discomfort. There is anemia and often numerous hemorrhages. Dark areas on the skin are common and these may occur irregularly on exposed parts of the skin with a deposit of yellow-brown patches which are not true jaundice. The bones show a motheaten, or punched-out appearance which is definitely weakening.
It is distinguished from Banti’s ‘disease” by its “predilection for childhood,” its occurrence in families, the early appearance of a brownish-yellow discoloration of the face and hands, a wedge-shaped thickening of the conjunctiva, and by the absence of ascites.

Etiology: Same as Banti’s “disease.”

Care of the Patient: These cases should be cared for as described under Banti’s “disease.” Removal of the spleen is not a cure.

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MOVABLE SPLEEN

Definition: This is a very rare condition which, like floating kidney, belongs to visceroptosis. The spleen is sagged down below its normal position and movable.

Symptoms: Displacement and movability of the spleen are the only symptoms.

Etiology: “There is no reason,” says Tilden, “why the spleen should not sag down below its normal position, from the same causes that allow the stomach, transverse colon, and other organs in the abdominal viscera to drop below their level. Great enervation, muscular relaxation, and intra-abdominal pressure from gas, etc., may occasionally displace, deform, and put out of their normal position any of these organs.” In malarial countries, where there is much enlargement of the spleen, the weight of the enlarged spleen, pulling heavily upon its attachments, may weaken these and displace the spleen downward.

Care of the Patient: If the subject is uncomfortable enough to seek a doctor, it will not be from the “wandering” spleen. It will be from indigestion, gas in the bowels, etc. Everything, therefore, should be done, to improve the patient’s general health. Other than this, care for the patient as directed under visceroptosis in this and Volume IV of this series.

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PRIMITIVE SPLENOMEGALY WITH ANEMIA

Definition: This is described as “a chronic disease of unknown origin, characterized by progressive enlargement of the spleen, anemia of the secondary type, leukopenia, a marked tendency to hemorrhages, and, in certain cases after the lapse of years, cirrhosis of the liver, with ascites and slight jaundice.” It is also called splenic anemia and Banti’s “disease.” We discussed its causes and the care of the patient under “Affections of the Blood” and will content ourselves here with merely adding some more descriptive matter.
Enlargement of the spleen, which may be the only conspicuous feature for years, is pronounced. Hemorrhages are usually from the stomach or bowel and are often profuse. Hepatic cirrhosis, with enlargement or atrophy of the liver, ascites, jaundice, etc., are late developments. The condition often lasts for years.
Early removal of the spleen is said to “frequently effect a complete cure.” This is on the principle that decapitation frequently effects a complete cure of headaches, or that removing the toe cures the corn. How can we continue to talk about cure when cause is unknown and not removed. See Splenic Anemia.

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RUPTURE OF THE SPLEEN

Definition: As the term implies, this is actual rupture of the spleen.

Symptoms: Symptoms of sudden collapse are the only new symptoms in these cases.

Etiology: Cases have occurred from great enlargement of the spleen from hyperemia, or engorgement of blood. The spleen may be ruptured by a blow or fall. Abscess of the spleen has been punctured and the intense swelling which followed has caused a rupture at the point of insertion of the needle.

Care of the Patient: This is a purely surgical case. There is nothing to be done except to open the abdomen and do whatever can be done to stop the hemorrhage.

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AFFECTIONS OF THE THYMUS

STATUS LYMPHATICUS

Definition: This is a mythical “disease” that is supposed to result from enlargement of the thymus gland and other parts of the lymphatic system. We rarely hear of it, except when a child dies from vaccination or inoculation.

Symptoms: The usual list of symptoms runs about like this: cyanosis, dyspnea, coughing, a crowing inspiration (much like croup), great nervousness, irritableness, proneness to collapse and, occasionally, sudden death.

Etiology: A great majority of youngsters in whom the X-ray shows a large thymus gland display no signs of abnormality, and the small percentage that do show signs of abnormality, show only the ordinary signs of toxemia, intestinal sepsis, or malnutrition. Investigations of sudden deaths attributed to status lymphaticus have shown lung conditions identical with those seen in animals that have died from serum poisoning — anaphylactic shock — and would indicate that, where these deaths are not due to serums and vaccines, they are the result of overwhelming the body with untolerated proteins.

Care of the Patient: Good general hygiene after a period of elimination, is all that these children require.

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AFFECTIONS OF THE THYROID

ACUTE THYROIDITIS

Definition: Inflammation of the thyroid gland.

Symptoms: Swelling and pain in all or part of the gland are the chief symptoms. The whole gland, one lobe, or the isthmus may be inflamed. If the inflammation ends in suppuration the gland may be destroyed.

Complications: Exophthalmic goitre is said to sometimes follow.

Etiology: This affection is seen as a sequel of pneumonia, typhoid fever, scarlet fever, mumps, and rheumatic fever. Septic poisoning of the gland is the cause.

Care of the Patient: Fasting and rest are the prime needs. If suppuration occurs, this may require surgical drainage.

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CRETINISM

Definition: This is a symptom-complex that develops in infants and young children in which there is hypothyroidism.

Symptoms: Arrested mental and physical development, with changes in the skin like those in myxedema with a characteristic deformity of the bones and soft parts are characteristic. The head is large, the features coarse and bloated, the expression stolid or idiotic, the trunk and limbs short and thick, the abdomen protuberant, the sexual organs infantile, and the skin rough and dry. Constipation, imperfectly closed fontanelles, delayed dentition, irregular teeth, deficient muscular development and lack of incentive and initiative, mental dullness, with varying degrees of backwardness, stupidity and, even, idiocy, are present. Children who live beyond the teething period grow up dwarfs with enormous sized joints.

Etiology: To attribute cretinism to thyroid deficiency is to stop at a half-way point. It is to overlook the deficiencies and excesses that are responsible for thyroid hypofunction. Perverted nutrition is responsible for the failure of the thyroid. Tilden says: “the fact that the child can be conceived shows that its state of health is good enough to allow its birth. The fact that the child is born with a derangement of its nutritive system is proof positive that the disease was started since conception. Parents live in such a haphazard way as to pervert their nutrition and pervert the nutrition of the unborn child. After such children are born they are fed improperly and cared for improperly, and naturally develop an infection. The infection takes place in the large intestine from putrescence. Why develop this kind of disease rather than some other? Because the nutrition of the parents for a generation or more has been perverted in such a way as to favor the developing of a diathesis favorable to the taking-on of this disease. The fact that several in a family can develop the disease is nothing strange. Why should not the same environment, the same thoughts, the same eating, the same habits — in short, why should not the same psychology and the same physiological influences — build’ similar derangements?
“The swollen abdomen of the child, if it proves anything at all, proves a perversion of digestion, with the evolution of a great deal of gas. The gas and these toxins are absorbed, and infect the blood. The decomposition in the large intestine is of a putrefactive character; and putrescence will certainly affect the whole system and disturb the nutrition generally, when absorbed.”

Care of the Patient: Giving gland extracts does not remove cause. We are dealing here with a perversion of metabolism growing out of a variety of causes, in which the thyroid deficiency is merely a link in a chain, and no attention that is confined to this link can ever hope to be successful.
The whole life and environment of the child must be improved. Feeding must be designed not merely to eliminate indigestion, but also to supply the body with needed minerals and vitamins. Animal proteins should be eschewed and fruits and vegetables fed within the digestive capacity of the child. A fast at the beginning will serve to eliminate toxins and normalize metabolism. Sunbaths are especially desirable in this condition.

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GOITRE

Definition: Known also a Basedow’s “disease,” Yorkshire neck, hyperthyroidism, goitre is enlargement of the thyroid gland.
The thyroid gland secretes a substance known as thyroxin, which acts as a catalytic agent in the process of oxidation. The human body contains approximately fourteen milligrams of thyroxin, although the amount varies under different conditions. Thyroxin is active in practically all the cel1 of the body. It quickens the rate of “transformation of energy” and is a regulator of metabolism. An elevation or depression of one milligram of the thyroxin content of the body results in a corresponding shift of 2.8% in basal metabolism. Hyperthyroidism is the term applied to the physiologic status that obtains when there is an excess of thyroxin in the body.

Symptoms: There are several classifications of goitre, but we shall here employ the one which we consider most simple and, therefore, most easily understood by the layman.

Simple hypertrophic goitre is a simple enlargement of the thyroid gland and may occur without any appreciable disturbance of function. It is frequent in young girls and often disappears at puberty. The voice and swallowing may be affected by pressure exerted by the enlarged gland.

Cystic or colloidal goitre is a thyroidal cyst containing a fluid or colloid substance within its capsule. It may affect, by pressure, the voice and swallowing.

Exophthalmic goitre receives its name from the manner in which the eyes protrude from their sockets — exophthalmia. There is an in. greased pulse rate, frequently running up to 140 and even 160 a minute, often violent palpitation, increased metabolism, nervous and mental symptoms, loss of weight and energy and often there is sugar in the wine.
Medical science (?) would have us believe that all the disagreeable symptoms peculiar to exophthalmic goitre are due to systemic poisoning from excess secretion. That this is not true is obvious from the fact that many of these symptoms precede the hyperthyroidism. The goitre is merely a link in a chain. Hyperthyroidism can exist without goitre and goitre can exist without hyperthyroidism. This being true, it is necessary to carefully weigh the so-called thyroid symptoms to ascertain where they come from.

Etiology: Hyperthyroidism (goitre) results from toxemia, the essential and ever-present first cause of over activity of the thyroid. To us, all goitres are toxic goitres. Supersaturation of the body with toxins from checked elimination, excessive eating of proteins, starches, pies, puddings, etc., and neglect of raw vegetables and fruits, and from various poison habits and the pyramiding of the effects of bad habits, is the cause of goitre.
The secretion of thyroxin seems to depend on an adequate supply of iodine and this has led to the belief that goitre is due to iodine deficiency. As goitre is usually associated with excessive secretion of thyroxin, and as lack of iodine should result in a deficiency of thyroxin, this theory of the cause of goitre would seem to be unsound. Certainly the practice built on this theory of cause has failed; failed both as a preventive and as a cure.
It has been shown experimentally that the thyroid gland may be stimulated into activity by sympathetic impulses and Cannon and others say that a continuation of such impulses over a considerable period of time produces a condition in animals like exophthalmic goitre in man. Clinical observations indicate that in men and women this condition may result from prolonged nervous strain or even that it may follow a single violent emotional disturbance.
Domestic and social discord, worry, irritation, etc., may easily produce enough sympathetic stimulation of the thyroid to result in exophthalmic goitre. Overwork, the various poison habits — coffee, tea, tobacco, alcohol, etc., habits — too frequent childbearing, or other drains upon the organism, and the various indulgencies common to modern living are factors in the production of goitre. We consider it very significant that among animals in captivity only carnivores suffer from goitre. Vegetarian and fruitarian animals are not so affected.
The thyroid gland is very closely linked with the sex glands. Apparently there is a more fundamental relationship between the female sex organism and the thyroid than between it and the male sex organism. At least disturbances of the sex functions in females have a more profoundly disturbing effect upon the thyroid than do disturbances of the male sex functions.
The sex factor in the development of goitre has not received sufficient consideration. Dr. Weger says that in practically all female goitre patients who have reached maturity and also frequently in girls who have just past puberty there is an intimate association and pathological involvement of the ovaries or uterus or both. “In the majority of cases there exists a small uterine fibroid. * * * In many cases the uterine tissues are themselves in a state of fibrous induration and enlargement. Almost invariably there is found a complicating chronic endometritis or endocervicitis with retained secretions.”
Tilden says, “thyroid enlargement is secondary to uterine and ovarian perversion in the female, and gonadal perversion in the male, and the perversion of these reproductive functions is super-induced by over-indulged appetite and passion for the most part by suppressed lasciviousness and salaciousness.” Again: “I have never seen a case of goitre in women who have not been troubled with toxemia and who have not been suffering with gastro-intestinal catarrh and a catarrhal state of the womb. I have found drainage from the womb invariably imperfect.”
“The thyroid and mammary glands are auxiliary to the reproductive system and anything that perverts the functions of the reproductive organs causes abnormalities of the thyroid and breasts.” “Lumps in the breasts,” so generally scare-headed into cancer, are invariably associated with the same kind of pelvic derangements as is goitre.
In goitre, the breasts of the female are often enlarged and the glands hard and sensitive. The womb is often enlarged and sensitive with catarrh and even ulceration of the neck or the body of the womb. The imperfectly drained (retained) secretions of the womb undergo decomposition and are highly toxic.
Sexual repression is especially common in females and many of these repressed women are as lascivious as any libertine. If married, they enter the sexual relation without responding, consciously or subconsciously (usually the latter) repressing themselves, and thus helping to pervert the functions of the thyroid.

Prognosis: Dr. Weger says “most hypertrophic goitres can be made to absorb. Absorption of a cystic goitre is a very rare occurrence.” Dr. Tilden says: “exophthalmic goitre can be cured just as easily as a fibroid tumor of the uterus can be cured. Indeed, these diseases can be cured even after many of the heads of the surgical profession of our leading cities declare that they cannot be cured without an operation.”

Care of the Patient: Complete and ultimately successful recovery can occur only, as Dr. Weger says, if “the patient is put to bed in an environment that will insure absolute physical and mental rest — away from friends and even relatives. The reasons for this are only obvious to those who have had experience in getting nervous patients under control. Outside influence and interference are sometimes insurmountable obstacles and always decided handicaps.”
We emphasized above the office of nervous irritation, domestic difficulties, etc., in overstimulating the thyroid. It should be obvious to anyone how necessary it is to get away from the sources of these disturbing factors. Proper rest of the nervous system is not possible so long as they exist. Physical and mental rest are vitally important in goitre cases.
Toxin elimination is best secured by fasting — physiological rest. This will also hasten the absorption of the enlargement. Indeed it often results in a rapid reduction and disappearance of the thyroid enlargement and hardening in the breasts and womb or ovaries. Dr. Weger adds: “Physiological rest can best be obtained by a complete fast. All foods must be withheld and nothing but water given until the pulse is normal and all active symptoms have subsided.”

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HYPEREMIA OF THE THYROID

Definition: This is an excess of blood in the thyroid gland.

Symptoms: Thyroid hyperemia is a transient state that sometimes develops during menstruation. It belongs to a syndrome. The lymphatic glands of the pelvis are more or less affected; there is hyperemia of the ovaries, a tendency to painful menstruation, or flooding, perhaps uterine catarrh, and hyperemia of the breasts with sensitiveness of the nipples. The catarrh in these cases, being due to the hyperemia, is transient.

Etiology: Toxin absorption from decomposition in the intestine is present in all such cases.

Care of the Patient: During the hyperemic stage either no food at all, for one to three days, or nothing but fruit for this time, is best. The condition is permanently eradicated when decomposition is eliminated. This necessitates stopping all improper eating, the eating of candy and other foods between meals, and living in a manner to insure good digestion.

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MYXEDEMA (Hypothyroidism)

Definition: Hypothyroidism is the term applied to the condition resulting from deficient function of the thyroid. Myxedema is a symptom-complex attributed to a lack of thyroid secretion and characterized by brawny thickening of the subcutaneous tissues, loss of energy and mental deterioration.

Symptoms: There is a gradual swelling of the subcutaneous tissues, especially on the face and hands and the regions above the clavicle. Unlike edema the parts do not pit on pressure, but are firm and elastic. The skin is dry and harsh; the hair becomes brittle and falls out and the thyroid gland is atrophied (wasted). Characteristic of the condition is a peculiar slowness of speech, thought and movement. Dementia may ultimately develop. There is frequent pulse and subnormal temperature. The special senses are impaired and such sensory abnormalities as undue sensitiveness to cold, neuralgic pains, and a sensation as if ants are crawling on the body (formication) are common. The sexual functions are impaired.

Etiology: Myxedema is said to be caused by thyroid deficiency. This is due to medicine’s habit of stopping at a half-way point in its search for cause. They are so accustomed to starting with an established pathology as cause that they do not go beyond the pathology in the thyroid in their search for the cause of myxedema. The thyroid deficiency is but a link in a chain. The thyroid deficiency does not cause itself. It does not just happen without cause. The deficiency of the thyroid secretion is not the cause of the deficiency of thyroid secretion. The real cause lies back of the deficiency, in the perverted metabolism of the patient. Operative myxedema or cachexia strumipriva is myxedema following complete removal of the thyroid gland.

Prognosis: Proper care instituted early may result in recovery. The tendency of the condition is to become progressively worse. This, we think, is due to persistence of cause.

Care of the Patient: To give thyroid extract does not remove the cause of thyroid deficiency. It does not restore health to the thyroid gland, nor to the body as a. whole. It will not cure wrong life. Whatever of apparent benefit flows from this procedure is short-lived and can last only so long as the extract is given — given in increasing doses. At best it is only a doubtful palliative.
Only by removing the primary cause — as summed up in enervation and toxemia — can these cases really be restored to health. There is no cure for glandular insufficiency, except to correct the habits of life that are responsible for the enervation which has ended in secretory block. The use of gland extracts in these cases is a failure. The failure of insulin in diabetes is typical of the failure of all other gland extracts. Gland extracts may be used as a crutch by those whose glandular impairment, is too great for vital redemption or for compensation. All others should know that these extracts produce their own damages in the body and also that their use leads to an ignoring of cause.

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