TREATMENT OF CHRONIC HEART DISEASE BY LOWERING THE METABOLIC RATE

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Abstract
In several previous communications the treatment of chronic intractable heart disease by removal of the thyroid gland in toto was demonstrated as a feasible and effective procedure in patients without clinical or pathologic evidence of thyrotoxicosis.1The success of this type of therapy was the logical result of an extended series of observations on the circulation in chronic heart disease, hyperthyroidism and myxedema,2from which the conclusion had been drawn that by reducing the basal metabolic rate one would lessen the demands on the circulation and relieve the diseased heart of its burden. These considerations were equally applicable to congestive failure and angina pectoris.3The permanent reduction of the metabolic rate was accomplished by surgical removal of the entire thyroid gland, according to the technic developed by Berlin and first performed by him, Dec. 15, 1932. This is the first time that a total ablation of the