Exothalmic goitre : lesions of the cervical ganglia / by R. Shingleton Smith.

  • Smith, R. Shingleton.
Date:
1878
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Licence: Public Domain Mark

Credit: Exothalmic goitre : lesions of the cervical ganglia / by R. Shingleton Smith. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    terine observed was, however, too small to warrant such a definite conclusion. The absence of any such change in the other ganglia, and, on the other hand, the absence of cal- careous or caseous glands elsewhere, must leave us in doubt as to the essential nature of the commencing lesion, and as to the exact tissue involved. ' Whether any morbid process affecting a small portion only of the cervical sympathetic system may be considered as a sufficient cause of the whole train of symptoms present in Graves's disease, is open to question. Accordingly, we are not justified in assuming that this was the primary or even the most important lesion present. In most of the cases where morbid appearances in the sympathetic system have been observed, the pathological condition has been one of sclerosis : an excess of connective tissue has given rise to a wasting of the nerve elements. Dr. Eeith records a case of exophthalmic goitre where this condition was observed {Medical Times and Gazette, 1865) ; Poniklo describes a similar condition in the sympathetic ganglia of diabetes (Lancet, February 23,1878). In the case now published no such increase of the connective-tissue ele- ment and no increased infiltration with connective-tissue nuclei were apparent. The condition observed was one of true atrophic shrinking of the nerve-ceUs proper. Such a lesion of the cells, not in one ganglion only, but affecting aU and equally so, may be supposed to give rise to such symptoms as exist in the disease under consideration. We must not, however, forget one important fact, viz., that the ganglia had been submitted to the prolonged action of a weak solution of chromic acid (one-half per cent.). This reagent is weU known to have a powerful action on nerve-ceUs ; it causes them to become granular and contracted. In the spinal cord and brain-tissues this contractile action of chromic acid on the