If the original noci-stimulus is withdrawn before the fear of the
disease becomes too strong, and before too much injury to the brain
and the thyroid has been inflicted, a spontaneous cure may result.
Recovery may be greatly facilitated by complete therapeutic rest.
A cure implies the return of the brain-cells to their normal state,
with the reestablishment of the normal self-control and the
restoration of the thyroid to its normal state, when the impulses
of daily life will once more have possession of the final
common path and the noci-influence will be dispossessed.
The discovery of the real cause of a given case of Graves' disease is
frequently difficult because it may be of a painful personal nature.
Of extreme interest is the fact that, in the acute stage,
the patient may be unable to refer to the exciting cause without
exhibiting an exacerbation of the symptoms of the disease.
I presume no case should be regarded as cured until reference
can be made to its cause without an abnormal reaction.
It has been established that in Graves' disease injury to any part
of the body, even under inhalation anesthesia, causes an exacerbation
of the disease. Fear alone may cause an acute exacerbation.
These acute exacerbations are frequently designated "hyperthyroidism"
and are the special hazard of operation.

In applying the principle of anoci-association in operations on
patients with Graves' disease there is scarcely a change in the pulse,
in the respiration, or in the nervous state at the close of the operation.
I know no remedy which can obviate the effect of the inflowing
stimuli from the wound after the cocain[*] has worn off.[t] It
is necessary, therefore,