Struma exopththalmica (vascular bronchocele and exophthalmos ) / by Professor Virchow ; translated, with notes and observations, by J. Warburton Begbie.

Date:
[1868]
Catalogue details

Licence: Public Domain Mark

Credit: Struma exopththalmica (vascular bronchocele and exophthalmos ) / by Professor Virchow ; translated, with notes and observations, by J. Warburton Begbie. Source: Wellcome Collection.

    4/16 (page 4)
    heart, great dyspnoea, pain in the abdomen; and in one of the cases it is mentioned that, in addition to these symptoms, u the staring look of the large eyes caused a very remarkable aspect.” These facts, notwithstanding, remained nearly unknown till the new experience of Pauli,1 Yon Basedow,2 and Graves,3 was pub¬ lished. Although the first communication of Graves appeared in 1835,4 that of Von Basedow has, notwithstanding, the advantage; the history of the disease having been, in the first place, completely given by him, and, through his knowledge, much information regarding it supplied. By Yon Basedow was originated the designations of exophthalmos, of the staring eye (Glotzauges) as the most striking feature, and of the cachexia exophthalmica, large staring eye cachexia (Glotzaugenkachexie), which has more recently become so universally known; and it is from this circumstance that, according to the proposal of G. Hirsch,5 it has been customary to style the whole assemblage of complex symptoms u Morbus Basedowii.” Trousseau,6 on the other hand, maintains that the disease should be termed u Graves’ disease.” I hold that this is not correct; for Graves regarded both the palpitation of the heart and the goitre as essentially symptoms of hysteria, while the condition of the eyes is only incidentally mentioned by him ; moreover, he is not the first wTho observed the complex symptoms. By recent writers, prominence has been assigned at one time to one, at another time to another of three principal symptoms; and, accord¬ ing to it, the choice of a designation for the disease has been made. Of late, the name u Struma exophthalmica” (goitre exophthalmique) has become very generally disseminated; but Lebert,7 having refer¬ ence to the affection of the heart, suggests for the disease the appel¬ lation of u Tachycardia Strumosa.” 8 The condition of the Thyroid gland is, during life, subject to variety. As a general rule, the swelling is not so great as that of the ordinary goitre, still a very marked enlargement is discovered. The most conspicuous feature of the swelling is an increased development of the vessels, with which, not unfrequently, a dia¬ stolic beat and u souffle” (ein diastoliches Klopfen und Kauschen) are perceived, so as to be directly styled “ Struma aneurysmatica,”9 or 1 Pauli, Heidelberger Medic. Annalen, 1837, s. 218. 2 Yon Basedow, Casper’s Wochenschrift, 1840, No. 13, s. 198. 3 Robert James Graves, Klinische Beobachtungen, Deutsch von Bressler, Leipz., 1843, s. 409. 4 Stokes, a. a. 0. S. 234. 5 G. Hirsch, Klinische Fragmente, Königsberg, 1858, heft ii. s. 224. 6 Trousseau, Gazette Hebdomadaire de Medecine, 1862, No. 30, p. 472. 7 Lebert, Die Krankheiten der Schildrüse, s. 307. 8 “Tachycardia” (t'a^vg, quick, Ko^/jc, the heart), in reference to the rapid and excited action of the organ. The exact term suggested by Lebert is “ tachycardia exophthalmica strumosa.” See his “ Grundzüge der Artzlichen Praxis,” 1867, s. 230.—(Translator.) 9 Henoch, Casper’s Wochenschrift, 1848, No. 40, s. 629. Romberg und Henoch, Klinische Wahrnehmungen und Beobachtungen, Berlin, 1851, s. 191. (Of this interesting paper, an abridged rendering by the translator will be