NOVEL SURGERY

Otago Daily Times, Issue 22447, 17 December 1934, Page 8

NOVEL SURGERY

HEART OPERATIONS REMOVAL OF THYROID GLAND. The great advances of surgery date from the comparitively recent time when the modern developments of the “ aseptic ” method made it possible to open regions of the body without the dreadful risks of blood poisoning as a matter of course. Abdominal surgery developed quickly after this “ discovery,” later the surgery of the brain was developed, aided in some ways by the catastrophes of war. In the post-war period there has been an effort in many centres to attack diseases of the lungs by surgical means, and now (writes a medical correspondent in the London Observer), there seems to be a possibility that even heart disease opens up a field where the surgeon can give valuable help. There have been attempts in the past to perform heroic feats, such as widening a narrowed valve, and removal of certain nerves for the relief of angina has also secured some support. The latest development is to remove the thyroid gland in cases of heart failure where all other means have been without effect. This appears at first sight to be a meaningless and almost barbarous attack by the surgeon upon a field where the physician alone has long reigned supreme. Reports of work on these lines have been coming from America for some time, and at certain centres in this country investigation of the method has been proceeding. SOME HOPE. In a recent issue of the British Medical Journal a report of a team of workers in Birmingham illustrates that the operation does hold out some hope of amelioration of symptons in otherwise “ hopeless ” cases. In six patients, all of whom had heart failure or angina, or. both, and in whom all other methods of treatment had failed to give relief, successful removal of the whole of the thyroid gland has been carried out. One patient with a very high blood pressure unfortunately succumbed to a “ stroke a few weeks later, but it is reported that although the time which has elapsed is still short, there has been “ fairly marked improvement” in the symptons in the other five. In all there has been an increased ability to perform exertions better and to greater extent than before. One housewife has been able to take up all her previous work with the exception of heavy washing! The explanation of this unusual line of treatment is not yet altogether clear. The originators based the removal of the thyroid gland on the following line of argument: The development of heart failure means that the heart is unable, to keep up sufficient circulation for the needs of the body tissues. This need of the tissues, mainly for oxygen, is controlled to a certain extent by Gie thyroid gland’s secretion. If this is very largely reduced by complete surgical removal of the gland the demands of the tissues are diminished and the circulatory system can cope with them in a more efficient manner. There are many points, however, which require more elucidation, particularly as regards the effect upon the other endocrine glands.