The prophylactic treatment of thyroid dysfunction and the importance of basal metabolism studies in obstetrics and gynecology

Abstract

T HE various glands of internal secretion have been the subjects of both laboratory and clinical investigation for many years, but organotherapy when applied to patients suffering from some type of gland dysfunction continues to be more or less unsatisfactory. The outstanding exception is the group of patients with thyroid dysfunction of the deficiency type who are greatly benefited from the administration of desiccated thyroid. Interesting experimental data are being reported from the administration of certain gland products or hormones, which indicate that progress is being made, but thus far the necessary dosage is much too expensive for the average patient since the results are of a temporary nature and the cost of the preparations too great for long continued usage. It is, therefore, fortunate that so many patients with endocrine dysfunctions are benefited from the use of desiccated thyroid which is the least expensive endocrine preparation owing to the large amount of animal material suitable for its manufacture. The relationship of the thyroid to the sex glands as evidenced by thyroid enlargement with menstruation, puberty, pregnancy, and the menopause as well as the increased incidence of goiter in the female was recognized by the ancients. The nature of this interrelationship still remains a problem for future investigations. Both clinical and laboratory investigations suggest a close relationship between the function of the thyroid and most other glands of internal secretions. It also seems probable from a purely theoretical point of view that measures directed toward the development of a normal thyroid in the fetus may prove to be of value in securing a more normal development of other glands of internal secretion. Fortunately, the epoch making observations and clinical experiments of David Marine have made possible an almost complete elimination of thyroid insufficiencies of the developmental type. In 1917 he reported that there is always some decrease in the iodine content of the thyroid during pregnancy and he urged the administration of iodine to prevent the hypertrophy of the thyroid which occurs so commonly among pregnant ivomen who live in goiter areas. More recent observations of Marine and others indicate t.hat simple goiter of the congenital type may be eliminated in a single generation, provided the mothers have proper medication during the period of pregnancy. However, it seems