Organotherapy in Gynecology: thyroid extract and uterine fibroids, endometriosis, etc.

article source: The Therapeutic Gazette, 1899

By W. A. Newman Dorland. A.M., M.D., Instructor in Gynecology in the Philadelphia Polyclinic; Assistant Obstetrician to the Hospital of the University of Pennsylvania.


THYROID THERAPY IN GYNECOLOGY

endocrine system, image, wiki

Of all the forms of organotherapy it will without doubt be safe to assert the marked preeminence of the extract of the thyroid gland. None of the glandular extracts have been more frequently used, and certainly none in a greater variety of pathologic conditions.
Whatever the physiologic action of the thyroid gland may be, it has long been recognized that its secretion—as also the ovarian —exerts a profound influence upon the body metabolism, though of a directly opposite and conflicting nature. Its presence in a normal degree is essential to the maintenance of the physical equilibrium. Thus, through the investigations of the pathologists, we now know that in cretinism and its allied condition, myxedema, either this gland or its functional activity is absent; and in those cases of exophthalmic goitre in which extirpation of the gland was practiced a most alarming train of symptoms shortly developed, directly traceable to the removal from the system of the glandular influence. An excess in the normal secretion of the gland will likewise be followed by an annoying series of phenomena such as will be noted in hypertrophy of the gland or in Basedow's disease.

At once two propositions suggest themselves, namely, in cases of the first class — that is, where there is absent or deficient thyroid action—the administration of thyroid extract to supply the deficiency should be followed by an amelioration of the clinical phenomena; and in cases of the second class — that is, where there is excessive thyroid secretion — extirpation of a portion of the gland or the administration of some antagonistic extract should result favorably. These propositions were shortly tested clinically and found to be sound in theory. The administration of the various forms of thyroid extract in cases of altered or absent thyroid function is always followed by a marked improvement of the condition present, while partial thyroidectomy has frequently resulted most advantageously in the treatment of exophthalmic goitre.

To clinical experimentation based on the foregoing theory must be attributed a series of interesting and unexpected results in thyroid therapy, such as the value of its employment in gynecologic and obstetric conditions, and its undoubted usefulness in the reduction of obesity. The rationale of its employment in the latter condition has been suggested by Robert Hutchinson, 1 who explains its action by an increased combustion of the nitrogen-bearing substances in the body, especially of the fat, but of the muscles also to a lesser degree.


Jouin f, 2 was the first of the modern writers to call attention to the close relationship existing between the thyroid gland and the pelvic organs, although Catulle states that this relationship was well known to the ancients. In addition to the influence exerted by the uterus — especially at the time of the menopause, when the ovarian influence is dying out—upon the size of goitres, he was the first to observe a diminution in the size of a fibroid tumor under the administration of thyroid extract given to reduce obesity. He obtained a considerable amelioration, and at times even a cure, of uterine fibromata and their symptoms, and of metrorrhagia rebellious to all other conservative means. In cases of purely functional hemorrhage the results had been a complete and lasting cure; also in those of hemorrhage at the menopause or dependent on flexions, versions, and other displacements. In his hands the growth of fibrous tumors was always checked by it,
and it often led to their retrogression. When it was employed early it cured them. In consideration of his results obtained in cases of this kind, as well as in the case of keloid and prostatic enlargement, he suggests that this method of therapy may be of value if applied to tumors of less advanced development, as, for example, sarcomata.



Hertoghe, 3 has found that women deprived of the thyroid gland are subject to excessive menstrual discharges; as they grow older the menses last longer, and finally become almost a constant flow. He has also noticed that a hypertrophied thyroid is always accompanied by an early and copious mammary secretion. He has demonstrated by tests on milch cows and other animals that the secretion of milk is much increased by the ingestion of thyroid extract. From his experience he concludes that myxedematous hemorrhage is directly amenable to thyroid treatment, and also hemorrhages due to even an old endometritis or ovaritis. Cancerous hemorrhages cease after three or four days of thyroidization. The pain, swelling, and congestion also decrease to a noticeable extent. Thyroid treatment, he claims, is especially indicated in cases of frequent abortion, in which the menstrual flow is so excessive that it sweeps away the impregnated ovum. He cites an instance of a woman who was able to conceive and bear a child through the action of thyroidin after many years of sterility. Thyroidin, he finds, is also useful in cases of uterine myoma, prolapsus, or retroflexion with hemorrhage, and, in general, in all cases in which it is necessary to reduce the size, sensibility, or congestion of the uterus. On account of the peculiar action of thyroidin in stimulating the lactal secretion, it should be administered if this secretion seems to be diminishing. It has also been found that in some phases of insanity, particularly those of the puerperal, adolescent, and climacteric periods, thyroid extract seems to have marked beneficial effects.

H. B. Stehman, 4 of Chicago, administered  thyroid tablets thrice daily to six patients exhibiting various forms of menstrual and other disturbances, including menorrhagia, metrorrhagia, amenorrhea, ovarialgia, and extreme nervousness. Each tablet represented about one-sixth of a sheep's thyroid. In each instance a most notable improvement was


  observed within the space of several weeks. It seems conclusive, therefore, that in these cases of pelvic congestion and sexual neurasthenia thyroid extract exerts a most remarkable and beneficial effect.



M. R. Latis, 5 believes that the thyroid juice exerts an inhibitory or vasoconstrictor power upon the pelvic genital organs, which is proved by the gradual diminution and final cessation of the menstrual flow under the prolonged use of the remedy. Menorrhagia and hemorrhages due to endometritis, ovaritis, and even cancer are greatly benefited by it.
Robert Bell, 6  quotes the experience of various surgeons and neurologists with reference to the thyroid gland and the genital organs. He states that Charcot, having seen women affected with exophthalmic goitre cured after pregnancy, did not fail to advise marriage, on therapeutic grounds, in the treatment of this disease. Bouilly, Tuffier, Guinard, Picque, and Bloch, having had occasion to operate on patients affected with fibroma of the uterus or salpingo-oophoritis, in whom coexisted goitres, some of which had previously resisted all treatment, have seen the thyroid tumors disappear, or at least be considerably diminished in size, after the extirpation of the pelvic organs. Bell especially emphasizes the pathologic relationship of the thyroid body to the womb and believes that the vitality of the latter may depend to a large extent on the integrity of the thyroid function. This fact especially seems to be exemplified by the marked prevalence of metrorrhagia in myxedematous conditions. He believes also that the thyroid gland especially influences the health of the skin and mucous membranes and subjacent connective tissue.

In three cases of uterine fibroids Kleinwachter, 7  found that thyroid extract exerted a favorable action in controlling the hemorrhage. In these cases the intermenstrual period was also prolonged or menstruation ceased entirely for a number of weeks. It was impossible to determine any diminution in the size of the tumors.

W. M. Polk, 8 states that during the past two years he has employed thyroid extract in fifteen cases of fibroid tumor of the uterus. In all but one he obtained good results. In four of the cases there occurred a distinct diminution in the size of the growth. He recommends the early and long administration of the extract in daily doses of 2% grains. 



J. Inglis Parsons, 9 employed thyroid extract in five cases of fibromyoma of the uterus. Four of these were women of about the age of forty years, with old hard fibromata of many years' standing. No appreciable diminution in size followed after a three months' course. In the fifth case, a young woman twenty-five years of age, with a large, hard, nodular fibromyoma almost filling the pelvis and dipping down into Douglas's pouch, there occurred a distinct reduction in size. The symptoms of morning sickness and attacks of retention of urine entirely disappeared in three months' time.



Having observed in conjunction with the good results following the employment of thyroid extract in the treatment of sporadic cretinism, myxedema, and some cases of mental feebleness, more or less marked increase in the activity of the metabolic processes of the body, Stawell, 10 was led to believe that the same agent might be reasonably expected to increase the metabolism of the mammary gland in suitable cases. Accordingly he employed thyroid tablets (presumably each representing one grain of dried gland), given from three to five times a day, in nine cases of nursing women, and in seven of these distinct increase in the quantity and apparent improvement in the quality of milk secreted followed.

R. v. Braun. J, 11 also reasoning from the same basis of profound alteration in the bodymetabolism as a result of thyroid medication, has suggested the use of the drug in obstetrics in cases of contracted pelvis in order to prevent heavy development of the fetus. He cites an instance of a woman with a funnel-shaped pelvis, protruding ischiatic spines, and an exostosis at the right iliopubic eminence, who had been delivered by craniotomy several months previously. In her succeeding pregnancy from the beginning of the fifth month she was put on one tablet of thyroidin daily. During the first part of the remaining period of pregnancy she increased slightly in weight, and during the latter part she decreased. The fetus seemed to remain small and was allowed to go to term. She was then delivered of a 3200-gramme living child. The previous child weighed 4000 grammes


 at birth. The difference in weight of the two children may or may not have been due to the thyroid in.



Cheron, 12 holds that thyroid extract is an excellent remedy in threatened abortion with hemorrhage, and is valuable in preventing the arrest of uterine involution after childbirth, and that it is potent against the premature return of the monthly periods. Moreover, it is a valuable galactagogue. In other, words, it stimulates the mammary secretion while it lessens functional activity of the uterus. In his hands it has also proved valuable in the control of all forms of uterine hemorrhage, whether this be due to endometritis, tumor, or lesions of the adnexa.

The contraindications to the employment of the drug are: tuberculosis, since this seems to be stimulated rather than arrested, and grave heart disease, where it should be administered with the utmost care, and should be discontinued at once upon the first suggestion of tachycardia. The symptoms of thyroid intoxication are tachycardia, oppression, exophthalmus, glycosuria, albuminuria, and irritability. In certain cases the drug produces rapid emaciation, and sometimes gastric vertigo will be observed.
Four cases of uterine fibromata and two cases of hemorrhagic endometritis have been treated by me during the past winter by means of thyroid extract, with the following results:

Case I.—A. E., colored, thirty-eight years of age, gave birth to her last child twenty-two years ago. She complained of great loss of flesh during the preceding six months, associated with severe radiating pain in the lower abdomen. Examination revealed a number of fibroid nodules on the anterior uterine wall. Five-grain tablets of thyroid extract were administered thrice daily, and in one week's time she reported a marked diminution in her pelvic pain.

Case II.—S. K., colored, aged forty-seven years, single, complained of pain in the back and right ovarian region, and a persistent though slight leucorrhea. Her menses had never been regular, and were now profuse. Under the thyroid extract in two weeks she pronounced herself much better. The duration and quantity of the menstrual flow were greatly diminished.

Case III. — M. M., colored, aged forty-eight years, had given birth to her last child thirty


 years before. She was suffering from the menopausal hot flashes, a constant leucorrhea, and pain in the back and left ovarian region. She had a small fibroid in the posterior uterine wall. On December 3, 1898, the thyroid medication was begun, and on the 16th she stated that she was improved and the pain in her back was gone. Four days later her menses began and lasted for four days, the shortest time for years. They had formerly been profuse and persisted for from seven to ten days. The leucorrhea was also much less in amount.



Case IV.—L. R., colored, aged thirty-five years, single, complained of pain in the left ovarian region, frequency of micturition, and a mucopurulent leucorrhea. Her menses occurred at three-week intervals and lasted profusely for five days. Examination showed the presence of uterine fibroids with a small mass firmly fixed in the pelvis and fibroid in nature. On September 13, 1898, the thyroid tablets were administered. One week later her pain was less and she thought she was a little better, though there was no change in the micturition. At that time the tumors seemed to be undergoing some alteration in shape, and the mass in the pelvis had become freely movable. Six days later she stated that she knew she was better than when she first came for treatment; she had less pain in the back and side. On October 6 she was feeling better generally; her menses had returned on September 27 and lasted three days. They were profuse, but no more than usual. On November 1 the tumor was decidedly smaller and freely movable. Her bleeding was not so pronounced. At her last visit, on December 6, all of her symptoms were relieved.

Case V.—K. G., white, aged twenty-seven, married three years, and sterile, came for the relief of sterility. Her menses had been profuse from puberty, lasting for five or six days, and always clotted. In August, 1898, rapid dilatation and curettage were performed in the hope of relieving the sterility. On March 3, 1899, she returned and stated that she had been flooding for seven weeks, and was suffering from severe left ovarian pain. Examination showed a slightly enlarged endometritic uterus. The thyroid extract was administered, and in forty-eight hours the bleeding ceased and has not returned at the time of writing. The pain also had disappeared and the patient was feeling well.


Case VI. — E. E., a single girl, nineteen years of age, had been flooding for three weeks. The uterus was normal in size, though very sensitive. Thyroid extract in doses of grains three times daily controlled the bleeding in three days time, and also materially lessened the amount of pain.

The following deductions would seem justifiable in the light of the foregoing reports:

1. The thyroid gland, in addition to its general effect upon the metabolism of the body, exerts an inhibitory action upon the pelvic genital organs, and upon the uterus in particular. This action seems to be especially marked upon the epithelial elements of the endometrium.

2. As a result of this inhibitory or vasoconstrictor action there follows a retardation of hemorrhages from the uterine mucosa.

3. This action is directly antagonistic to that exerted upon the uterus by the ovarian secretion.

4. In cases in which this conservative influence is deficient or absent, it may be restored by the ingestion of fresh thyroid gland or desiccations or extracts of that organ.

5. In gynecology, thyroid therapy is especially indicated in hemorrhagic affections of the uterus and in all forms of pelvic congestion, notably in uterine fibromata, hemorrhagic endometritis, menopausal hemorrhages, and chronic tubal disease.

6. The best results are to be expected in fibromata and pathologic conditions of recent development. The more chronic the case the more rebellious will it prove to thyroidization.

7. The thyroid influence is also found to cause an increase in the metabolism of the mammary gland, and the treatment is therefore indicated in all cases of insufficient lactation.

8. The drug may be administered in the form of the fresh gland substance; as a desiccated powder of the fresh gland; in tabloids of the desiccated gland; as the fresh juice; or in one of the various extracts of the gland, administered preferably in the form of tabloids. The same results may be obtained by direct transplantation of the thyroid gland from the sheep to the human subject. Because of the difficulty experienced in procuring the fresh gland and the repugnance which patients exhibit in consuming it, it is well to administer it in the dry form prepared by druggists—in tablets, pastilles, or capsules —in doses of 2% to 5 grains three or four times daily. The average daily dose is 15 grains.

9. Owing to the tendency to thyroid intoxication it is well to discontinue the drug for a period of a week to ten days at regular intervals during the course of the treatment.

1) British Medical Journal, July 16, 1898




 2) Nouv. Arch. d'Obstet. et de Gynic, 1895, No. 6; La Gynic, June, 1806.

3) Rev. Med., Jan. 4, 1899

4) American Gynecological and Obstetrical Journal February, 1897

5) Dublin Journal of Medical Science, Sept. I, 1897 

6)  Scottish Medical and Surgical Journal, July, 1897

7) Zeitch f Geb u Gynak, 1898

8) Medical News, July 3, 1897

9) Lancet, July 23, 1896 

10) Intercolonial Medical Journal of Australasia, April 20, 1897

11) Cent F. Gynak, 1896

12) Rev Medico-Chirurg, des Maladies des Femmes, Nov 25 and Dec 25 , 1896

Iodine and arsenic in menstrual blood

image source- wiki

M. Armand Gautier has some interesting theories concerning the menstrual function and the rut of animals in relation to the role of arsenic in nutrition. These were communicated to the Academie des Sciences on August 6th, and may be read in La Presse Médicale for September 8th, 1900. He traces a relationship between the functions of the genital organs, those of the thyroid gland, and the growth of the appendages of the skin, namely, hair and nails. His attention was attracted to the subject by the observation that patients, when taking arsenic, menstruate more frequently than at other times, that their skin improves in condition, and that their hair increases in length and thickness. Since arsenic and iodine are assimilated by the thyroid, and excreted by the epidermis and its appendages, it occurred to Dr. Gautier that it is upon the utilisation and elimination of these substances that the above-mentioned relationship is based, and his experiments have confirmed him in this opinion.

He has shown that normal blood of man and of animals contain no arsenic and a very little iodine, while menstrual blood contains .3 milligrammes of arsenic per kilogramme, and 4 1/2 times more iodine than normal blood. A human thyroid contains about 15 milligrammes of arsenic, so that, allowing for a blood loss of 400 to 500 grammes per day during menstruation, the total blood lost would contain 12 to 14 milligrammes of arsenic, or nearly as much arsenic as the thyroid of the patient contained before menstruation. Thus arsenic and iodine are excreted every month by woman, and menstruation finds its raison d’étre in a removal of these substances from the thyroid, and perhaps also, in less degree, from the skin.

Normally the nucleo-proteids and iodised bodies of the thyroid go to nourish the skin, and especially the hair bulbs and the nail beds. The arsenic and iodine thus used are eliminated by the shedding of hair and nails, and by the desquamation of the general surface of the epidermis. In woman there is an excess production of these bodies, which is eliminated periodically in the menstrual blood, unless conception occurs, in which case the excess is used up in the construction of the foetus, in whose rapid growth much phosphorus, arsenic, and iodine are consumed.

We are aware that the thyroid gland excites and regulates growth, that it influences the nutrition of the skin, and that it is in relation with the development and function of the reproductive organs. Its atrophy in the cretin coincides with arrest of development, myxo:dema, and infantilism of the sexual organs. On the other hand, the thyroid develops rapidly in the pregnant woman, and in certain females it hypertrophies some days before menstruation. Hofmeister has observed atrophy of the sexual organs after removal of the thyroid, and conversely it is stated that the administration of thyroid substance has been followed by renewal of growth in an infantile uterus. In a word, all the organs rich in nucleins, especially those in which arsenic and iodine occur together, are favourably influenced by the administration of thyroid substance.

It is mainly by the appendages of the skin and by the menstrual blood that arsenic and iodine are eliminated by the female human subject. It may be asked, however, how these substances are dealt with by the male subject, and by female animals which do not menstruate. Our author answers this question by pointing out that warm-blooded animals of both sexes are covered with hairs or feathers, which grow as a rule before the breeding season, and are shed to a considerable extent when the period of sexual activity is passed. Thus the supply of arsenic and iodine is used during the winter in growing fur, feathers, horns, etc. When these have reached their full growth the supply of nucleo-proteids is diverted to the sexual organs, and breeding commences. The skin is thus deprived of the essentials of luxuriant growth, the hair falls out, the horns fall off, and the feathers drop out.

Fabio, breeding plumage?

The human male is not, as a rule, covered with hair; but at the same time he is more hirsute than the female. The hair of his head and beard grows, and our author maintains his epidermal desquamation is more rapid than that of the smoother skin of the female, whose hair does not grow much after puberty is reached. The extra growth of hair in the male human subject is thus said to eliminate as much arsenic as is lost in the menstrual blood by the female. In other words, the girl only begins to menstruate when her hair stops growing, whilst, on the other hand, it is just at the same period of life that the boy’s beard begins to grow. Amongst hairy human races, in whom, as in monkeys, arsenical nucleins are largely used up in the production of hair, menstruation and the corresponding periods of sexual appetite would be expected to appear at longer intervals than in hairless humanity. The author has ascertained by inquiry from anthropologists that this is actually the case. He also finds that cutting off the hair of females, as is done in some religious institutions, provides a fresh outlet for arsenical products, and thus tends to check the menstrual function.

male snowy egret, breeding plumage~ wiki image

 The author illustrates his views by observations upon certain lower animals, notably many male birds, whose feathers grow to brilliance before the breeding season, and are shed like a wedding garment at its close. Other birds grow appendages on their beaks, which fall off after the breeding season. Amongst certain urodela a horny crest rich in arsenic decorates the tail of the male animal, and is reabsorbed during and after the reproductive period of the year. Lastly, the author mentions the various afiections of the skin which are common during pregnancy as evidence of the strain upon the production of arsenical proteids, which is caused by gestation. Myxedema, he finds, is a disease most common amongst multiparae, who have time after time drawn upon their reserves of thyroid~produced substances.

These views may appear to be vague, unproved, and even romantic ; they are, however, interesting and not without suggestiveness. It may be found, after experiment and extended observation, that they are based upon a substratum of solid fact. _

male mallard duck, breeding plumage, image source, wiki

article source: The Practitioner, Volume 65, 1900

We have all come up out of the Sea...

The thyroid may be looked upon as the organ evolved for maintaining the same amount of iodine in the blood as there is in sea water. Sea water was our original habitat, since, like Venus, we have all come up out of the sea.


The more intimate study of the composition of the blood has revealed the most astonishing parallelism between it and the compounds of sea water. The blood is sea water, to which has been added hemoglobin as a pigment for carrying oxygen to the cells not in direct contact with the atmosphere, nutrients to take the place of the prey our marine ancestors gobbled up frankly and directly, and white cells to act as the first line of defense. To keep the concentration of iodine in the blood a constant, the thyroid evolved, since there is no iodine in most foods and very little in those which do contain it.

The Birth of Venus~ Sandro Botticelli

source: THE GLANDS REGULATING PERSONALITY, A STUDY OF THE GLANDS OF INTERNAL SECRETION IN RELATION TO THE TYPES OF HUMAN NATURE 

BY LOUIS BERMAN, M.D. 

ASSOCIATE IN BIOLOGICAL CHEMISTRY, COLUMBIA University;

 Physician To The Special Health Clinic, 

             Lenox Hill Hospital 

1922

The passage from the miracles of nature to those 

of art is easy. 

—Francis Bacon, Novum Organum, 1620. 

THE SIMULTANEOUS OCCURRENCE OF TUMORS IN THE THYROID, UTERUS AND BREAST

THE SIMULTANEOUS OCCURRENCE OF TUMORS IN THE THYROID, UTERUS AND BREAST

MAX BALLIN, M.D. AND R. C. MOEHLIG, M.D.

DETROIT

article source: Journal of the American Medical Association, 1922


________________________________________________________________________________


Every surgeon who operates upon goiters must have noticed the frequent occurrence of tumors in the thyroid, uterus and breast. Apparently there has been very little written on the subject, however, for we could find only two references in the literature. Falta's 1 "Ductless Glandular Diseases" contains this note:

"There seems to exist a certain relationship between goiter and myomata of the uterus. At least it has been observed that in strumous women who also suffer from myomata the struma also decreases in size with the retrogression of the myoma at the menopause."

Falta's note is quoted from an article by Ullman 2  of Vienna. This article reads:

 thyroid gland

It has been known for a long time that a relationship exists between the uterus and the normal thyroid gland. The nature of this relationship is, of course, enshrouded in darkness; we only know that in a not infrequent number of women a transitory enlargement of the thyroid gland takes place at the time of menstruation. After the cessation of menstruation, the thyroid returns to normal. ... In many women during pregnancy an enlargement of the thyroid takes place, which still exists after childbirth. ... A third fact which concerns the question of the relationship between uterus and thyroid is that as to whether strumas develop more frequently in females then in males. ... I wish to emphasize that in women affected with myomas I was able to show a distinct enlargement of the thyroid gland, an enlargement that could be spoken of partly as struma parenchymatosa, partly as the result of degeneration, as colloid struma. ... I was then able to determine that these strumas following complete myomectomy became decidedly smaller; in many cases they disappeared entirely.

1. Falta, Wilhelm: Ductless Glandular Diseases, Philadelphia, P. Blakiston's Son & Co., 1916, p. 156.

2. Ullman. Emmerich: Ueher Uterusmyom and Kropf, Wicn. ktin. Wchnschr. 23: 58S, 1910.

In looking over our own records, we find that of the last 100 female patients who consulted us for goiter, eighteen had fibroids;  four of them also had breast tumors; and of the last 100 patients who consulted us for fibroids, thirty-five had goiter; six had breast tumors. Thus, of the total 200 patients, fifty-three, or 26.5 per cent., had tumors of both thyroid and uterus. Ten of these 200 patients required operations on both the thyroid and the uterus. This large number of multiple lesions is obviously much more than a coincidence; yet, as noted above, very little mention of it has been made.

The matter therefore seemed important enough to call attention to again. Three points suggest themselves:

(a) It is possible, as suggested by Ullman, that certain goiters might be reduced in size or even cured by removal of a fibroid.

(b) Thyroid extract and iodin might be beneficial in preventing the development of fibroids as well as of goiters.

(c) These relationships might have some bearing on the etiology of these tumor groups.

fibrocystic breast tissue

In the eighteen goiters found in the examination of 100 fibroids, fourteen were adenomas of the thyroid, three were colloid goiters, and one was an exophthalmic goiter. Of the four breast tumors which accompanied goiters, an adenofibroma with cyst-areas accompanied an adenomatous goiter; an adenoma of the left breast accompanied an adenomatous goiter; an intracanalicular adenofibroma in the right breast, and a similar tumor with hyaline changes in the left breast accompanied a colloid adenomatous goiter. Another goiter which is not tabulated showed virginal hypertrophy of the right breast. Of the six breast tumors which accompanied fibroids, three were interstitial mastitis; one was a fibro-adenoma; one was a carcinoma of the left breast and fibro-adenoma of the right breast, and one was a cystadenoma.

uterine fibroids

Of the fifty-three patients with the combination of goiter and fibroid, the youngest was 25 years old, this patient being the only one below 30. Fully two thirds were over 35. We may say, therefore, that the incidence mounts with age, the simultaneous occurrence of goiter and fibroid being most prevalent in the latter half of the third decade and during the fourth decade. Of the 100 goiter patients, twenty-one were under the age of 25. There were no fibroids among these patients, so that the percentage of eighteen fibroids is borne by seventy-nine patients more than 25 years of age. In other words, the fibroid-goiter combination shows its entire incidence after 25 years of age, and increases rapidly after 35 years.

The simultaneous occurrence of goiters, fibroids and breast tumors is more frequent than is usually supposed. The thyroid, breast and uterus have different anatomic structures and are different in their embryologic origins, but we note that the function of the thyroid is closely related to, and influences the function of the sexual organs. The interrelationship of uterus and breast is obvious. Since these organs are related to each other only by function, it must be that physiologic interdependence is a factor in the tumor formation.

normal breast tissue

When sexual function ceases or begins to wane, usually the time arises for the growth of all these

tumors. The symptoms of fibroids usually become more alarming toward the end of the reproductive period. The adenomatous goiter, in the great majority of cases, does not give much discomfort until the menopause. Then pressure and toxic symptoms arise. Small tumors in the breast have often existed from the age of 20 to the age of 40 without giving any symptoms, or without having been noticed at all; still, their long-standing existence usually is clear when their presence becomes obvious through growth or discomfort. Because of the aforementioned functional (physiologic) relationship which exists between thyroid, uterus and breast, we may be able to understand why growth or irritation in one of these organs may induce growth or irritation in another. For instance, when a small fibroid which has existed innocently for many years suddenly begins to grow, it may induce growth or irritation in the thyroid or breast (and vice versa).


CONCLUSIONS:


1. In a series of 200 cases (100 fibroids and 100 goiters), fifty-three patients, or 26.5 per cent., had both goiter and fibroid. Five per cent, had breast tumors.

2. The age of incidence of these combinations was greatest after 35.

3. Since these three organs are not related anatomically or embryologically, the simultaneous occurrence of tumors in the thyroid, uterus and breast may be explained by their physiologic interrelationship.

4. The prophylactic treatment now advocated, of giving iodids for goiter, may likewise prove beneficial in the prevention of fibroid.

5. Perhaps certain goiters can be reduced in size or even cured by the removal of a fibroid (as suggested by Ullman).

all images- wiki commons

Toxic Breasts

BENIGN MAMMARY TUMORS AND INTESTINAL TOXEMIA*
By William Seaman Bainbridge


•Read at the Thirty-third Annual Meeting of the American Association of Obstetricians, Gynecologists, and Abdominal Surgeons, held at Atlantic City, N. J., September 20-22, 1920.


Wow, just wow. It seemed to be well-known, back in the day, that digestion was key. This physician cured lumpy breasts with adjustments in diet, laxatives, colonic irrigation and enemas. He also cured the condition with various surgeries, occasionally removing cysts but in the majority of cases the surgery was abdominal, removing adhesions and generally rearranging the organs and such. I have chosen to include only those cases that were cured by hygienic methods, if you wish you can follow this link and read all about the cases which required surgery:


American Journal of Obstetrics and gynecology, Volume 1



 It is worth noting that Dr. Bainbridge was able to save women's breasts via these abdominal surgeries, in fact saving breasts that had been deemed cancerous by other physicians.







The present paper purposes to record a series of twenty-five eases of abnormal mammary changes apparently caused by autointoxication. When these cases are seen in their early stages the breast condition is often overlooked; when they have developed into a more easily recognized state, frequently a diagnosis of malignant disease is made.


Each of the cases reported herein suffered from a coexistant chronic intestinal toxemia, and the amount of poisoning was reflected, in many instances, in the degree of change in the mammary tissue. When the autointoxication was relieved the breasts either markedly improved or returned entirely to the normal.


These cases classify themselves, more or less, into three groups. 1. Those with a condensation or lobular induration of the upper, outer quadrants of the breasts, usually along the edge of the large pectoral muscle, and where the dependent breast drags on the upper axillary margin. This occurs in both mammae, but more frequently in the left. Such terms as "toxic breasts," "lumpy breasts" or "stasis lumps" are descriptive of this condition. 2. Those cases that have, in addition to the above, and in the same region, localized degeneration with adenomata or cystomata. 3. Those that have an abnormal discharge from the nipple in conjunction with one or the other of the above conditions.


The diminishing of the gastrointestinal fermentation by diet, digestives, intestinal antiseptics, high alkaline colonic irrigations, and certain physiotherapeutic measures, is of distinct value. The use of these agents, together with a support to the breasts and a proper uplifting abdominal corset, often result in a complete disappearance of the breast lumps or tumors. However, some of the cases require surgical intervention of the underlying abdominal condition before the toxic poisoning is sufficiently relieved as to noticeably benefit the breasts.


In those cases where there is a cyst or adenoma in addition to a general lobular condition of the breasts, the removal of the growth and the correction of the intestinal stasis, by medical or surgical means, often result in the mammae becoming completely normal. A preliminary lessening of the general toxic condition, in some cases, materially helped in locating the real existing benign neoplasm, and hence it was made possible to save a considerable amount of curable breast tissue. By this means the patients were saved the mental and physical shock of an unnecessary amputation.


Case 1.—I. I.; age thirty-five; female; single. First seen May 12, 1919. Constipation with usual symptoms of intestinal stasis; backache. On examination, found floating right kidney; general enteroptosis; mass of feces in lower colon; considerable gas in ascending and transverse colon; marked lumpy condition in upper, outer quadrant left breast. Prescribed tonic, laxatives, uplifting corset belt; special abdominal exercises, and general hygienic regime. June, 1920: Patient in excellent health; constipation relieved; no longer any lumps in breast. September 1920, passed examination to enter training school for nurses of large metropolitan hospital.


Case 2.—E. S.; age thirty-three; female; single. First seen September, 1898. Marked constipation; frequent attacks of intestinal gas; distinct lumps in upper, outer quadrant of left breast; nipple normal. Very much worried about cancer. Prescribed diet, cathartics, and support to breasts, with very careful and frequent examination. Six months after treatment was begun lumps in breasts disappeared. For some years, patient noticed that if she became constipated and had "indigestion," there was a return of the lumpy condition. This was relieved by thorough catharsis. August, 1920: Breasts perfectly normal.



Case 3.—J. L.; age thirty; female; single. First seen January, 1919. Subacute attack of rheumatic fever; feet extremely swollen; painful; intestinal indigestion; headaches; nausea; marked constipation. On examination found intestinal stasis; large lumps in both breasts; enlarged glands of neck; swelling of feet and ankles. Prescribed diet; high alkaline colonic irrigations; salicylates, for a short time, cathartics, with physiotherapy as able to take it. September 1920: Under treatment, swelling and pain in joints of feet and elsewhere gradually disappared. Lumps in breasts entirely gone after two months. Twice she allowed herself to become constipated and to be indiscreet with diet and at both times noticed a soreness and distinct lumpy condition of breasts, which disappeared upon resorting to careful treatment.

Case 4.—W. R.; age twenty-eight; female; married. First seen November 27, 1906. Rectal abscess and cyst of perineum removed. In 1919 complained of intestinal gas; loss of weight; constipation; soreness of breasts, worried about cancer. On examination, found gastroptosis; ascending colon and hepatic flexure clogged with fecal matter; considerable gas; distinct lumpy condition throughout breasts, more marked in upper, outer quadrant. Prescribed abdominal and breast supports; laxatives; high alkaline colonic irrigations several times a week; diet; tonic; special exercise. June, 1920: Patient stated she was no longer a "nervous wreck"; when careful of diet and bowels there is no soreness in breasts. Considers herself well. August, 1920: Excellent condition; breasts normal.

Case 5.—A. G.; age forty-eight years; female; married. First seen December 9, 1918. Complained of pain and discomfort in left breast. On examination, found breasts very large, dependent, and the inner quadrant of left one slightly lobulated; no real tumor formation. Prescribed breast support; laxatives, with usual hygienic regime and careful watching. June, 1920: Lumpy condition of breasts entirely relieved—still a little soreness; constipation improved.

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SUMMARY

1. There are definite abnormal changes in the breast tissue, as in the thyroid gland, from intestinal toxemia.

2. Treatment by medical and mechanical means, or surgical intervention for the cure of the intestinal stasis, often means complete return to the normal of the lumpy or toxic breasts.

3. At times it is necessary to remove a definite, localized tumor from the breast, in addition to the above, before the mammary tissue regains its normal texture.

4. Care must be taken that these abnormal changes are not overlooked in their early stages; and not diagnosticated as cancer when well developed.

5. In this connection, an important question must be noted: Would an early recognition of a toxic breast and timely and efficient treatment of the underlying intestinal causes, tend to lessen the danger of malignant degeneration? If this is so, then we have here an important contributory factor in the etiology of cancer of the breast.

Praying for a cure

Hmmmm... an interesting story from an old children's magazine. The moral of this particular story seems to be to be very specific in your prayers.


And to take your iodine!

From  "Golden Hours, A Magazine for Boys and Girls", 1878

LISA rose early, with her mind fully made up. She slipped on her skirt, took her apron and bodice in her hand, and patted down a rocky path which led from Mere Gillott's hut to a spring. Kneeling down by the hand-wide stream which trickled from the spring, she bathed her face, arms, and bosom, and said her prayers, looking toward the east. She wiped her smooth, fresh skin with her apron, and smoothing back her hair, gave it a twist under a kerchief. Then she put on her apron and bodice, and her toilet was made.

Lisa did not know much about the world. She thought all earth was a mountain, with bits of huts dotted here and there, and the universal holidays only such as were kept in her native canton. There was nobody to teach Lisa. She lived in a little hut with Mere Gillott, who was a bent, half-alive old lace-weaver, more ignorant if possible than Lisa herself.

It was a Church holiday, and Lisa had permission from her mistress to spend it in the usual way, in games with the boys and girls, and in company with the whole population, who left work and devoted that day to prayers and feasting and sociability.

After making her toilet she looked very sweet and pretty, though she had neither shoes nor hat. Her wooden shoes must be kept for the cold Winter; her sun-tanned feet must go bare in Summer. Some of the girls who would gather at the festival would wear shoes—real shoes!—but Lisa was not envying them or even thinking of them. She went into the hut. Mere Gillott slept still; her feet moved softly over the earthen floor; she got a thick slice of black bread, a round ball of Swiss cheese and a cup, then she went to the door and called the goat. The goat came near, and Lisa milked some of the thin milk into her cup, and sitting on a stone, ate her breakfast.

The sun was now rising. The air grew lighter, and warm with splendors. Long slants marked distant peaks; the mist rolled cloud over cloud down into hollows. By the time Lisa's breakfast was eaten the sun sprung above the horizon. She now took the garden sickle, and went to the sweet marjoram bed. She cut her apron just as full as she could carry it of sweet marjoram. It was heavy with dew, and Lisa dipped her face into it with delight.

She was now ready to start. But not to the merry-makings which would be kept around the church. She was going up the mountain, on what many would call a superstitious errand. As she came out of the garden, and turned toward the hut to hang up her sickle, the goat clattered up and thrust her nose into Lisa's apron, nibbling the pretty green and white herb.

"Begone, Nanine.'' said Lisa; "this is not for such as thee."

She pulled out a handful for the goat, and hung her sickle on the nail. Then she look the winding and devious path which led up the mountain.

Mere Gillott's hut stood close by the Avail which surrounded an old chalet. Here lived the minister, whose family were all dead, and his housekeeper, a woman so old that nobody in the region pretended to guess at her age. Nevertheless she was still brisk and sharp-eyed. The girls were always glad to sit in groups and hear Mere Grisa talk. Her experiences were marvelous, and they gathered up the very crumbs of her superstition and treasured them.

A few days before the festival Mere Grisa condescended to chat with Mere Gillott. The minister's housekeeper wore a high black cap; the old Gillott had nothing but a black kerchief to her head. Lisa watched them nodding and chattering toothlessly, and wondered how it would seem when she, too, was old. How would she like to have her plump cheeks curve in instead of out? to go bent over, leaning on a stick or crutch? to see her hands and arms shrivel, and all things grow dimmer than they were at present? She did not like the thought. She loved being young and buoyant and strong. She loved to feel her limbs full of spring, and to see such long distances. On the other hand, however, one can not have experiences without growing old, and how all respect the dignified aged!

"It is true," said the somewhat childish old Mere Grisa to Mere Gillott, "I have seen it happen thus again and again. If any one has a heart's desire which he wishes to accomplish, let him try it. Why, there was the mountaineer, Hochuly. His girl wandered from him. Not one in the canton could tell where she was. He roamed aimlessly up the mountains. Not a chamois could tempt him. Then some one—it may have been my great-grandson, Ernst—told him what Mere Grisa knew of the shrine. 'Take an offering there,'said Ernst, 'and you will get your heart's desire.' Hochuly roamed about till, being near the shrine one day, and the words ringing in his ears, he hunts edelweiss and lays it on the shrine. Then, as a Christian man should, he said his prayers, and when he got up from his knees there stood his child Marie, and they flew into each other's arms."

"Yes, yes," said Mere Gillott, "I have heard the tale."

"Where is the shrine, good Mere Grisa?" hastily put in the listening girl.

The old dame peered up at her from under bushy eyebrows.

"And what hast thou to do with a shrine?"

"Why, if folks get their heart's desire by laying such offerings as they can get upon it, I have a heart's desire, and I will go there—yes, and take my ear-rings, if they would do."

"Prut!" ejaculated Mere Grisa. "What are they, little trumpery ear-rings. Art an idol-worshiper, to lay metals and such earth upon a sacred shrine? Take something green and flourishing—something the good God has fashioned, and not a trinket made by man, such as papists deck their waxen figures with. I fear thou ait too rattlebrained to be sound in the faith."

Lisa colored, and her eyes filled.
"I did not know what to take," said she. "My ear-rings are all I have, except my bodice and kerchief and apron and skirt. I would give any thing for my heart's desire."

"Wouldst, eh? Well, what is thy heart's desire, silly thing? A new apron and bodice, and a lover to fill thy head with flattery."

Lisa's face flamed indignantly. "O Mere Grisa! why do you judge me so cruelly? I do not look at any of the young men, and they do not look at me."
"Pooh! it's natural; it's natural", chuckled the old woman.

"And my bodice and apron are quite strong yet," continued Lisa.

"Then what is left for such a chicken as thou art to desire?"

Lisa hung down her head.

"Come, I'll not tell thee where the shrine is unless thou tell what's the heart's desire."

"Mere Grisa, I have a sister—Claire."

"With thy old grandmother, who lives beyond the pass?"

"Yes, Mere Grisa. She is—" Lisa hesitated.

"So I have heard," said the old woman, nodding her head. "Well, and what of that? If she is a cretin it can not be helped."

A tear like an angel's finger traced a bar down Lisa's face. Mere Grisa dimly saw that glistening track; she had a kind old heart.

"Well, child, I was only telling the Mere Gillott that if a believing person goes to the calvary at the light hand side of the Two Brothers' Pass, and takes some little offering in the hand, the heart's desire shall be appeased. It is only a saying in this region. We who are old never expect impossibilities."

"But I know the Two Brothers' Pass," cried Lisa, eagerly, "and I know the shrine. I was once up the mountain as high as that. It is a very old wooden cross fastened in a pile of stones. The figure was blown off it long since, they say."

In consequence of this gossip with Mere Grisa, therefore, the girl set out, as I told you, on this holiday morning, and her destination was not the motherly old church, but the high cross, standing lone on its heap of stones by Two Brothers' Pass.

Lisa clambered cautiously. Her bare feet were hardy, but some of the goat paths were quite steep and full of jagged points. When she had ascended some distance she felt more exhilarated than ever. Some of the people were already gathering to the fete below. Usually Lisa was ready for play and merry-making too. She was too full of her errand, however, to think an instant of play now. She believed that her heart's desire would be given her as soon as she reached the shrine and put down her bundle of sweet marjoram.

"Not on account of the sweet marjoram, though," murmured Lisa. "I did not know any better thing to take. I will ask very distinctly that Claire may be cured, that she may never be a simple cretin any more. What other real heart's desire could I have? I would willingly wear this apron and bodice till I die if Claire could be like other girls. Oh, to see her look up clear and bright at me, instead of dull-eyed, and that horrible pouch hanging from her throat down upon her breast! If Claire were not a cretin, if the goitre were gone, how happy we might be! All our lives we could take such comfort with each other. I wish I had known about this making offerings at the shrine long ago. Why, I would carry sweet herbs up the mountain every day, after my work is done, as long as I live, if Claire could be cured!"

In the simplicity of her heart Lisa continued, as she toiled up and up:
"As soon as I lay the bundle of herb down, I wonder if Claire will stand there cured
as the old mere tells of Hochuly's Marie. Marie appeared to him that moment. How rejoiced I should be! What pleasure it is to look forward to happiness! Shall I take her to the fete? How astonished all would be to see poor Claire standing erect, no goitre upon her poor neck!"

The devious path wove back and forth like a slim shuttle across the dark loom of the mountain. The sun did not grow hot. In that high latitude Lisa would not have been too warm had not exercise opened all her pores. She climbed until past noon, and then sat down for a few moments to rest.

It was a long way to the entrance of Two Brothers' Pass. She never had approached it by this route before, and began to wonder if she were going right. It was much easier to think of making the ascent than to make it.

Lisa had some bread and cheese in her pocket, and she nibbled at it. Then gathering her marjoram closer, she climbed on. Perhaps the lines of her face drooped a little. She grew very tired; but her faith in her errand was great—strong enough to move the mountain itself.

It was late in the afternoon, when the lone wooden cross started out of a cliff side upon her sight. How drear upon its heap of stones! Lisa toiled up to it. Her fair holiday was two-thirds gone. Here was the goal of her efforts. The last quarter league was longer than any other part of her journey. She approached the foot of the pile of stones. It seemed that the story of the region had had other believers.

 Some bunches of dried flowers lay on the stones. A pin-scratched bit of writing was on one of the round stones. Lisa stooped and looked at it, but she could not read, and therefore did not know that it said in blasphemous French:
"Whoever is superstitious fool enough to come here as I did, will go away a convicted fool, but less superstitious."

Lisa looked up at the cross. It must be very lonely in the dark nights. It half-terrified her. She spread down her sweet marjoram on the stones. Then she knelt by it, and told her heart's desire fervently. The mountain echoes handled her little voice very softly. She got up and looked around, really expecting to see Claire, goitreless and lovely, standing close at hand. No one was near her. Her heart turned sick. She got down on her knees again, and waited with a patient waiting. Time moved over the mountain in silence.

"Lisa," called a voice, very tenderly. Lisa turned her head and saw the spiritual, beautiful face of Kaspar, the young mountaineer, who lived nearest her grandmother's hut. He was standing leaning on his alpenstock, his eyes full of sympathetic knowledge of what she was doing. She rose up again, and exclaimed, eagerly:

"Where is Claire?"

"She is cured," said Kaspar, approaching. "I was coming by the Two Brothers' Pass to fetch you to your grandmother's."

"But why didn't Claire come too?" cried Lisa. "When did it happeri? How does she look?"
"I have not seen her since she was changed,"said Kaspar; "but I should think she looked beautiful and happy. You were saying your prayers at the old cross for her, were you?"

"Yes: I was praying that the goitre might leave her, that she might get well and stay so always."

"Well, come with me," said Kaspar; "the change has been made, but you must get accustomed to it."

In time Lisa stood by the bed and looked at her Claire; and the tears trickled down her young, sweet face, but her heart could not break as it might have broken once if she had seen Claire lying before her dead.

The goitre and the idiocy were truly cast off by her sister; even Claire's dead face looked fairer than it ever did in life, and somebody had covered the hideous swelling of her neck. The old grandmother was bustling about the hut; she wiped a tear or two, but Lisa was her favorite, and she did not love the idiot girl as Lisa did.

"She's gone," said the grandmother.

"Cured," breathed Lisa.

"Yes, cured," said Kaspar, putting a hand on her shoulder, "only better cured than you thought to ask for her to be."

Amber beads as a goiter remedy

 AMBER.

goiter

"Goitre is so common that, unless the neck be very thick, it is not considered to be anything abnormal; hence my first table will only show most unmistakable goitres.
Many well-known facts will also be seen brought out strongly—as the greater tendency in women, and the greater liability of the right side.

I obtained from the villagers their ideas as to causes, and subjoin these in the order of their belief:—Family; water; parturition; strains and coughing; overcrowding; cold..
As to sources of relief, they mention—wearing of flannel; pressure of shirt-collar; heavy bead necklaces; change of residence, and climacteric change."


source: The Lancet, 1872


"Thyrocele or simple goiter is most common in young girls at puberty. As a rule, it subsides in a few months without treatment. The wearing ofamber beads is supposed by the laity to have a curative effect upon goiter—it is in these cases that such good results are obtained and tend to keep up the superstition."


source: The International journal of surgery, Volume 26, 1913

amber necklace

Q. What effect does an amber necklace have upon goiter?

A. The same effect as a moss agate cuff button.


source: Buffalo Sanitary Bulletin, 1914





"In spite of investigations ...Laymen and physicians are still in mystery about it(goiter). Superstition, ranging from the wearing of a chain of costly amber beads ..."

source: Eclectic Medical Journal, Volume 78, 1918

amber

"From the earliest times amber has been supposed to operate as a charm, so that it has been used as an amulet, and for purposes of ornament it is the most ancient of all gems (Legends of Gems). It is a congener of Jet, with which it is found. It is highly electric, so that the Greeks called it electron—hence the name electricity. Pliny states that a necklace of amber beads would guard against secret poison and keep off witchcraft and sorcery.

Amber was, and still is, used as a remedy for all throat affections, including goitre, and also as a cure for pain in the stomach, jaundice, asthma, gout, dropsy, heart disease, and dysentery."

source: Archaeologia, or, Miscellaneous tracts, 1871

all images courtesy of Wiki Commons