Volume 1

The internal secretions and the principles of medicine / by Charles E. de M. Sajous.

  • Sajous, Charles E. de M. (Charles Eucharist de Medicis), 1852-1929.
Date:
1911
Catalogue details

Licence: Public Domain Mark

Credit: The internal secretions and the principles of medicine / by Charles E. de M. Sajous. Source: Wellcome Collection.

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    nutrition, but, as there exist many gradations of this condition, hypothyroidia representing as many degrees of thyroparathyroid secretory activity, its symptoms are more or less prominent both in number and intensity. These patients usually apply for relief of pain of some kind, particularly pain in the back or in the occipital region, and oc¬ casionally for migraine or neuralgia. The “backache” may con¬ sist of sacrolumbar pains, of coccygodynia, or in most instances of very severe de^p-seated pain between the shoulder-blades, which rest in bed tends to aggravate rather than to improve. These phenomena are due to deficient catabolic activity, the blood being laden with toxic products—a known cause of such symptoms. That rest in bed should aggravate the condition is self-evident: it merely slows still more the oxidation process and thereby encourages the catabolic torpor. They complain of feeling fatigued, languid, somnolent on rising, and of being in every way worse; while, as the day wears on, their condition improves. Their temperature is low, and they complain of always feeling cold, especially at the extremities. Their hands are flabby, damp, though cold chills may even be complained of. We have here an evidence of the slow metabolic activity referred to above, every sign of deficient oxidation being present. This explains also why a copious meal, especially if it includes the use of alcoholic beverages, should be a source of great relief in these cases, and why, also, they readily become addicted to the immoderate use of alcohol as a “stimulant.” A close examination then reveals other morbid phenomena which are obviously due to the defective nutrition of all tissues which hypothyroidia entails. The patient appears much older than her age—women constituting a large proportion of these cases. The hair may be prematurely gray, showing a marked tendency to fall in patches from the forehead and median line, which tends to become wider, and from the occiput. This loss, which is attributed by the patient to the headaches, may be such as eventually to cause complete alopecia. In marked cases the hair may be coarse, dry, and brittle, as in the cretin. The eye¬ brows also show a tendency to fall, but, a characteristic sign of hypothyroidia: the loss is limited to the external or outer ends. This shortening of the eyebrows and the occipital loss of hair