The advance had still to be made from pathology to treatment. Here, so
far as England is concerned, honour is again due to Sir Victor
Horsley. On 8th February 1890, he published the suggestion that
thyroid-tissue, from an animal just killed, should be transplanted
beneath the skin of a myxoedematous patient:--
"The justification of this procedure rested on the remarkable
experiments of Schiff and von Eisselsberg. I only became aware
in April 1890, that this proposal had been in fact forestalled
in 1889 by Dr. Bircher, in Aarau. (The date of Dr. Bircher's
operation was 16th January 1889.) Kocher had tried to do the
same thing in 1883, but the graft was soon absorbed; but early
in 1889 he tried it again, in five cases, and one greatly
improved."
The importance of this treatment, by transplantation of living
thyroid-tissue, must be judged by the fact that in 1888 no practical
use had yet been made of the scientific work that had been done. The
Clinical Society's Report, published that year, gives but half a page
to treatment, of the old-fashioned sort; and not a word of hope.
Then, at last, in 1891, came Dr. George Murray's paper in the _British
Medical Journal_, "Note on the Treatment of Myxoedema by Hypodermic
Injections of an Extract of the Thyroid Gland of a Sheep." Later,
hypodermic injections of thyroid-extract gave way to sandwiches, made
with thyroid gland (Dr. Hector Mackenzie, and Dr. Fox of Plymouth),
and these in their turn were eclipsed by tabloids.
It is a strange sequence, from 1873 onward: clinical observation,
_post-mortem_ work, calamities of surgery, experimental physiology,
transplantation, hypodermic injections, sandwiches, and tabloids. And
far more has been achieved than the cure of myxoedema. Even if the
discovery stopped here, it would still be a miracle that little
bottles of tabloids should bring men and women back from myxoedema to
what they were before they became thick-witted, slow, changed almost
past recognition, drifting toward idiocy. But it does not stop here.
The same treatment has given good results in countless cases of
sporadic cretinism, restoring growth of body and of mind to children
that were hopelessly imbecile. It is of great value also for certain
diseases of the skin. Moreover, physiology has gained knowledge of the
purpose of the thyroid gland, and a clearer insight into the facts
relating to internal secretion.
XIII
THE ACTION OF DRUGS
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