An unusual case of Graves' disease / by James Craig.

  • Craig, James.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: An unusual case of Graves' disease / by James Craig. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    3/8
    prevents tlie lids from meeting over the eyeballs, every precaution should be adopted by the medical attendant to lessen the corneal exposure and reduce the proptosis. The methods that have been found useful for these purposes are, tightly applied muslin bandages over the eyes, the application of tincture of iodine to the upper lids, and when the protrusion is very great, the eyelids may be stitched tegether, or even, in order to lessen the palpebral orifice, the upper and lower lids should be united in the region of both commissures, by vivifying their edges for some distance and stitching them together so as to bring about a permanent union. However, it is only right to mention that a young girl who was undergoing an operation of this sort died suddenly on the operating table at Guy's Hospital, in June, 1873, but this untoward result may scarcely be taken to prove more than that a tendency to sudden death exists in exophthalmic goitre. Since the three cardinal symptoms of this affection were first grouped together by Graves as a separate and definite malady, many additional symptoms have been described, some of which, like tremor, are almost constantly present, while others are found with more or less varying frequency. I cannot enter upon these at present, but most of them have been mentioned by Dr. Foot in his particularly interesting and instructive lecture on Graves's disease which appears in the second series of International Clinics. He there also calls attention to the undoubted right of associating with this malady the name of its discoverer—Graves—rather than that of Basedow. So that it is interesting to find, in the most recently-published German treatise on Exophthalmic Goitre,, an admission by the author, Dr. Mannheim, of Berlin, that in studying the histoiy of the affection he discovered that Graves had known, recognised, and described the disease before Basedow, and that therefore one could not refuse to give him the priority and name the disease after him, Morbus Gravesii, and this he adopts as the title of his work. I could not attempt, within the space of a short paper, to ^ discuss fully the various theories that have been put forward with 1 regard to the pathology of this perplexing disease. But while it iis almost universally accepted by writers on nervous diseases, and \hj pathologists generally, that the symptoms owe tjieir origin to sa functional or organic lesion of the central nervous system, but • especially to that part of it—viz. the medulla oblongata, in which are ssituated the cardio-inhibitory, vaso-motor, respiratory, and other