EDITORIAL NOTES AND COMMENTS


The symptoms of cocain poisoning usually appear quite promptly. They are ushered in by a period of nervousness and excitation, sometimes almost of hysteria. Respiration is rapid and deeper than normal, and the pulse is markedly accelerated. The throat is dry, and the patient may complain of a choking sensation. The pupils are dilated, owing possibly to direct action on the muscular fibers of the iris.


CONCERNING EXOPHTHALMIC GOITER.-At the annual meeting in May of the American Association of Physicians, the results of iodin administration to patients having exophthalmic goitre were discussed by several old school men of prominence. The Journal of the American Medical Association publishes the proceedings and discussions and states as follows:

“RESULTS OF ADMINISTERING IODIN TO PATIENTS HAVING EXOPHTHALMIC GOITER.

“Dr. H.S. Plummer, Rochester, Minn.: It has been taught that iodin should not be administered to patients with exophthalmic goiter, on the ground that it causes hyperfunction. There are two entities included in the term hyperfunction. There are two entities included in the term hyperthyroidism: first, exophthalmic goiter, second, hyperfunctioning adenomatous goiter. In the latter, the basal metabolism is more nearly normal. In exophthalmic goiter there are certain symptoms: (1) nervous phenomena, (2) eye symptoms. The first include purposeful but useless movements. The higher psychic processes are chaotic.

The patients cannot explain why they cry or laugh. In the vegetative nervous system there is the same process of imbalance. These signs have given rise to such terms as sympathotonic or vagotonic goiter. These symptoms seem to be due to underlying metabolic disturbances. Often, after slight operations, the temperature rises and death occurs in a few hours. We judge the differential diagnosis by the nervous phenomena, which, if excessive, point to a great surgical risk. The eye phenomena are two: the exophthalmos, or protrusion of the eyeball, and the stare which fluctuates with the nervous phenomena.

Anything that will overstimulate the thyroid can give the clinical picture of exophthalmic goiter. In such cases, the normal hormone, thyroxin, is not completely iodized. This incompletely built up thyroxin, as it leaves the gland, can enter into catabolic reaction faster than the normal, stable molecule and raise then metabolic rate more rapidly. If, therefore, we can change the character of the molecule, we can change the basal metabolism. If there is intense metabolic stress for lack of iodin, death occurs from lack of iodin.

From this it follows that if we can change the production of abnormal substance to properly iodized substance we can cut down postoperative mortality, avoid crises, and change the picture of the nervous phenomena. Acting on this plan, we administered 10 drops of compound solution of iodin for ten days following operation, with the result that we have found there is no such things as postoperative deaths from hyperthyroidism if this dosage has been administered to the patient with regularity. In other words, the patient is relatively short of iodin, and dies from lack of it. When we replace the iodin, we do away with postoperative deaths.

“DISCUSSION.

“Dr. H.A. Hare, Philadelphia: Is it not true that, in districts of the United States in which goiter is very prevalent, iodin is lacking? Would it not also be true that in such an area there would be a higher percentage of poor operative results? It would be interesting to know whether in non-iodin-bearing areas, the surgeons would need to reinforce their procedures by iodin administration.

“Dr. Haven Emerson, New York: In Rochester, N.Y., there is a lack of iodin, and the municipal health authorities have been putting iodin into the water supply. This would forestall any tendency on the part of the community to develop endemic goiter. The proportion of iodin in the thyroid gland has some relation to the kind of food, and that varies in the individual, and from time to time, and also in geographic areas, so that the average clinical picture may very according to the geographic location. In England, the iodin-bearing sea breezes produce a different atmosphere than that in the Mississippi Valley, for instance. Probably, the mortality in geographic areas inferior in this respect could be overcome, or balanced, by sufficient iodin supply. In any case in which the gland is cut short of iodin supply there is a potential stimulus to hyperthyroidism because of production of abnormal thyroid secretion”.

Rabe R F
Dr Rudolph Frederick RABE (1872-1952)
American Homeopathy Doctor.
Rabe graduated from the New York Homeopathic Medical College and trained under Timothy Field Allen and William Tod Helmuth.

Rabe was President of the International Hahnemannian Association, editor in chief of the Homeopathic Recorder, and he wrote Medical Therapeutics for daily reference. Rabe was Dean and Professor of Homeopathic Therapeutics at the New York Homeopathic Medical College.