A Clinical Lecture on Two Cases of Lupus Treated by Thyroid Extract: Delivered at the Edinburgh Royal Infirmary
Authors: B. Bramwell
Journal: BMJ (1894)

TiHYlROID EXTItACT IN LUPUS.'TilY l{f)D EXTicltu"r 1x l.ui'us..I ZINDICAL J4t'^X^t *8 S7On Mlarch itl, :-;0 iiniiims; of Br-ady itiid Mai-tin's e-xtract, alsed on MJareli stli ail(d lotll lalf a lobecofficesli thyroid wei-e given.On1 Mai-eh lltli, 1(i Iiiiiiis oi Ili-ady aiid .Martinl's extract, aiid )o1Marchi12tb. lalf a lolbe of tlle fresli gland.Tllis (lose-lo iiiiiiln-of liradly aii(I Malrtiii's li(juidl extract oiic dav, andl lialf a lobc o)f tlle frecli glaiicdtlle net.dal;ywas t-oiitiiiued uiitil itairali 2L1nd, wlheii lile doste was redluced to 5 Iiiiimiis of tlle litluidl ex.trac t, aiidl a quar ter of a lolbe of the fresl glaiid oin cacli alteriiate day.The paticiit coiitiiiuedl to t.skce this dose-5 INiiiilns oile dy aiid a quai ter of a lobe of fresli tliyroid ttie next diay-untilApr>il l3th li u1bitlie3fi-esli gland was finallydeiscoiitiinucd,and 1Sdrops of Ili-ady aind Martin's lluidelcx.tiact of t}lyioiti were giveii every day.Tlisdosewas-coiitiiiiied uiitil Mtay ul)tl,when tle patieiit was isent to the C'oiivaleseent Hoiiic.Tlle results of t11e ti-eatitncit were as follows:February 14tll (tliedlay after tllc tliyr-oidl treatinent was eomitienced).The patient feels sick,alnd comuplainlsof feeliiig tired and s3ick; 8lic wais therefore kiept in bed.Fcbur tltit.The patient says sihe is iiiucli better, auid tllat slie is hungy Thtemperature lias risen to 99c F. Tlle face feels less hot, and it criIly looks ]ess red and auigry.Xome of tlle crusts seem to be drier thiai) t-hey were before the treatinent was coiinienlced.February 18th.The patienlt says tllat tlle face feels a great deal bettoer, sudl that it is ntot nearly so tiglit.Tllere is more suppuration over the nose.The patchi below the riglit eye seems to be iinproigFebruary21st.The patient says that she feels quite Iel Tllere fseems to be rather more suppurationl, and soine fresli crusts over the left clteek.In1 ot'her places wbere tlle lupus nodules are sinlall-as on the rightside of the face below tbe eye-tliere is a distinct improvement.February2;3rd.The lialf lobe of thyroid, wlileli was again admiliiitered yesterday, lias not produced any -siciEness or disturbance.February2:'7tlh.Tlle patient conltinues to feel quite well.March ISt.Some of the crusts liave fallen off the face is c:ertainly better; it is much eooler looking and less red.March 17th.The patient says that tlle feeling of heat and tighltness in -the face has entirely disappeared.Most of the crulsts have disappeared from the right side of the face, leaving a healtlhy cicatrix in their place.April 1:ith.The fresh thyroid to beg discontinued and the patient to take 15 minims of Brady and Martin's extract every day.The face coll- tinues to improve.Some of the scabs on thle right clieek, upper i'p, and nose, lhave fallen of.The redness lias almost entirely disappeared; the outlying nodules are inuch less noticeable.the disease becanme severe fiv-e yeal s ago.October liti.The face continues to 1111p,rove.October 21st.The patienit agaiin compllained 'of painl ill tile abdlosiieu, weaknes.4,licadaclie, and general onalaise ) (menstrual disturbance).Tliy- roid suspended.October 28th.The patieiit feels quite well;* tlhyroid resutiied.N6vember 4tlb.The patient was dissliarged very lijiuih imnpsorove but not cured.November 13ti.Tlle patient was readiiiitted for furthier treatillelit.Thne tace does'not look quite so wrell as it did a forttiight ago.Tell i iiiiiims oftyodetatt be takren each dav.Noveilbr 2th.Face again 'improviiig.November235th.Menstrual disturbance. (pain ill the lower part of the abdoiniei, hleadache, general malai8e) again recurred but there has beeii no maenstrual flax.Thyroid suspeiidea.November 28th.Patient feels well; thlyroid resumed.De¢ember 13th.Dose of thYro'id increased; *S0 minims of-Brady and Martin's;extract (three 10-minim doses) each day.Decefmber 20th.Patient shown to the Medico-C,hirurgical Society.December 30th.Menstrual disturbane, saiiie symptoms as before; thyroid suspended.Ja u3rd, 1894.T.hyrid rsmd* 10 minims three times in the day.Januark, 14th.Patient complains of headache and vomiting; tongue clean; pulse 108; face very much flushed;* thyroid omitted.January 16th.Patient better; thyroid resumed.January 17th.Patient was again showii