The non-surgical treatment of exophthalmic goitre / by Solomon Solis Cohen.

  • Solis-Cohen, Solomon, 1857-1948.
Date:
1912
Catalogue details

Licence: In copyright

Credit: The non-surgical treatment of exophthalmic goitre / by Solomon Solis Cohen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    disorder, but I have heard it commended. Theoretically, it should be ‘‘guarded” with a digitalis drug. Topical Treatment. Is it, or is it not, advisable to attempt to reduce the goitre by local measures? I believe that it is, in many cases; and despite the fact that the internal administration of iodides usually aggravates the Graves’ phenomena, I have observed no bad results, but only good result or no result, from topical applications of iodine preparations. Of these, the solution of iodine in liquid saponified petrolatum seems to be the best. Interesting theoretic considerations are suggested by this fact; but I will only say that if the gland has hypertrophied in response to a demand from the system for the storing of iodine therein, so that this ele- ment may be delivered into the blood stream in an acceptable form, the artificial supply may enable it to reduce its activity. Electricity has been utilized in various ways. Cataphoric, or as it is now termed, ionic, application of iodine has been made; the galvanic current has been passed through the gland, and applied over the neck in the neighborhood of the cervical sympathetic. In my own hands, the most satisfactory form of electric application— in that minority of cases in which any such treatment has seemed necessary—has been the high frequency discharge from an Oudin “resonator” in connection with a Tesla coil, Leyden jar battery, and static influence machine. Sometimes the electrification is directed to the goitre; sometimes to the back of the neck in the neighborhood of the vertebra prommens; sometimes to both. This application, how- ever, has been used only in mild, early cases, in which absolute rest has not been indicated; or else, when the improvement has so far progressed that rest may be intermitted or given up; for it means that the patient should be able to visit the physician’s office two or three times weekly. It is of auxiliary benefit, but would not alone bring about recovery. How lasting the result may be one is not yet in position to say, as I have used this particular modality only during the last three years. There are many other medicinal and physiological measures of more or less benefit in certain cases of Graves’ disorder, but those discussed or mentioned are suflScient to indicate the.general char- acter of the non-surgical treatment that has been found of service. It is not specific, although it is special; and it is highly individualized. Serums, etc. Before concluding, a word should be said as to the various serums and antibodies that have been proposed and used. My own experience with Rogers^ and Beebe’s serum has thus far been inconclusive; although it is only fair to say that I speak after a very limited trial. It produced remarkable, but not permanent, good results in two cases; and failed entirely in two other cases. That it has great possibilities cannot be gainsaid;