The effect of iodine on hyperthyroidism in man / by S.J. Cowell and E. Mellanby.

  • Cowell, S. J. (Stuart Jasper)
Date:
[1924?]
Catalogue details

Licence: In copyright

Credit: The effect of iodine on hyperthyroidism in man / by S.J. Cowell and E. Mellanby. Source: Wellcome Collection.

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    symptoms, but it became clear that the iodine effect was complicated and that its influence varied greatly according to such circumstances, among others, as size of dose, duration of treatment, and type of case. It was decided to make a closer study of its action, and work was directed to finding out how it acted and the conditions under which its best therapeutic effect could be obtained. The results of the investigation are described below. It is clear that an investigation of this nature has a wider interest than that dependent on its immediate or even its ultimate clinical value. It has been seen above that iodine controls largely the structure of the thyroid gland, but that the evidence that it influences metabolic processes in the body, although such processes are greatly affected by thyroid activity, is small. This situation appeared enigmatical. However, the dramatic effect of iodides in hyper¬ thyroidism makes it clear that thyroid function as well as structure may be greatly influenced by this substance, and that the physiological action of iodine cannot be explained simply by the fact that it forms part of the active principle thyroxin. We have had in our minds throughout this work the hope of shedding further light on this relationship between iodine and thyroid activity, as well as finding out the conditions under which the best clinical results can be produced in cases of hyperthyroidism. Methods. Patients suffering from various types of hyperthyroidism have been kept under observation in hospital, and records of their basal metabolic rate, pulse- rate, weight, neck measurement, and general clinical condition have been made at frequent intervals. The patients received during their stay in hospital a standard diet, the energy value of which was in the neighbourhood of 1,800 calories. It was usually arranged as follows : Breakfast: 1 egg, 3 oz. bread with jam, -J pint milk. Lunch : ^ pint milk. Dinner : 2 oz. lean meat, 4 oz. potatoes, 4 oz. green vegetables, small portion of milk pudding, 1 orange. Tea: 3 oz. bread with jam, tea with a little milk. Supper: \ pint milk. The basal metabolic rates were determined by the Douglas bag method and the pulse-rat&s recorded on the accompanying charts were taken while the patients were at rest under as nearly as possible basal conditions. It should be mentioned that the conditions for obtaining ‘ basal ’ measurements were not ideal; with one exception (Case I) the samples of air had to be collected in a general ward, although by the use of screens the disturbing effect of outside influences on the patients was to some extent avoided. Iodine was given in the form ol potassium iodide. The administiation was begun at varying intervals after the patients admission^ in some cases after they had been resting in hospital for six weeks or two months. The largest amount