Steubenville, Ohio, Sept. 23, 1907.
To the Editor:
—In your answer to the inquiry of Dr. H. M. Metcalf, in The Journal, Sept. 14, 1907, page 959, concerning the treatment of simple goiter, I fear that not quite enough stress was laid on the efficacy, in many instances, of thyroid extract. I have seen many patients apparently cured of simple goiter by the administration of thyroid extract alone, without the use of external applications or of iodin. While it is barely possible, although almost inconceivable, that exophthalmic goiter may rarely be the result of thyroid feeding-as claimed by Osborne and Rogers—this should not deter us from the use of such a sovereign and comparatively harmless remedy. The thyroid gland certainly decreases in size during its use in the majority of patients. When it is given in gradually increasing doses and suspended temporarily on the appearance of the first signs of