In another and more common affection, the patient is attacked with tremors, at first slight and confined to the fingers, afterwards violent and extending to the whole muscles of the arms and even of the trunk. At the same time there is excessive and rapidly increasing weakness, a sense of anxiety and sinking, a total suspension of the function of digestion, rapid and extreme muscular emaciation, tendency to fainting, and violent continued palpitation,[348] accompanied sometimes with absorption of the testicles in man, and of the mammæ in females. In the midst of these phenomena the curative powers of the poison over the disease for which it has chiefly been used, namely, goître, are developed. It has been remarked in particular, that the diminution of the goître keeps pace with the diminution of the breasts, though at times either effect has been developed without the other. An instance is related in Rust’s Journal of a female, whose breasts began to sink after she had used iodine for four months; and in four weeks hardly a vestige of them remained; but her goître was not affected.[349] An American physician, Dr. Rivers, has twice noticed barrenness apparently induced by the prolonged use of iodine; and as in these instances the females were young and previously very prolific, but ceased to bear children from the time the iodine was used, his observations seem worthy of attention.[350] Dr. Jahn[351] specifies among the leading effects of the poison when slowly accumulated in the body,—absorption of the fat,—increase of all the excretions,—dinginess of the skin, with frequent clammy sweat,—hurried anxious breathing,—diuresis and an appearance of oil floating in the urine,—increased discharge of fæces, which are unusually bilious, but free of mucus,—increased secretion of semen,—increased menstrual discharge,—swelling of the subcutaneous veins and lividity of the lips,—feebleness of the pulse, with superabundance of serosity in the blood,—impaired digestion and diminished secretion of saliva and mucus. This affection, which, in conformity with the name he has given it, may be termed Iodism [_Iodkrankheit_], he contrasts with mercurialism, the constitutional effect of the accumulation of mercury in the body; and he considers the former not more unmanageable than the latter. The dose required to produce these effects are very various. Some people appear almost insensible to its action; in one instance, nine hundred and fifty-three grains were taken in daily portions varying from two to eighteen grains, without any bad effect;[352] and I have known an average of four grains daily taken for fifteen months, with the effect only of increasing the appetite. On the other hand, Dr. Gairdner has seen severe symptoms commence when half a grain was taken three times a day for a single week;[353] and Coindet has seen bad effects from thirty drops of the solution of ioduretted hydriodate taken daily for five days.[354]