Thyroid secretion as a factor in exophthalmic goitre / by George R. Murray.

  • Murray, George Redmayne, 1865-1939.
Date:
1893
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Licence: Public Domain Mark

Credit: Thyroid secretion as a factor in exophthalmic goitre / by George R. Murray. 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.

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    those cases in which the symptoms of exophthalmic goitre have disappeared and those of myxcedema have developed afterwards. Dr. Gowers 12 has observed “ myxoedematous swelling of the eyelids and pigmentation of the skin to follow permanent recovery from exophthalmic goitre. ’ ’ Dr. Corkhill13 has recorded a case in which symptoms of Graves’ disease were followed by myxoedema. In the discussion on Mr. Maude’s paper Dr. Ord said that he had seen symptoms of myxoedema develop after the enlarged thyroid gland had been too rapidly reduced in size by treatment, and Dr. Bowles mentioned two cases in which there had been Graves’ disease in early life followed by myxoedema afterwards. It is an interesting fact that the disappearance of the symptoms of exophthalmic goitre in these cases should be followed later by distinct symptoms of myxcedema due to atrophy of the thyroid gland ; and may it not have been a gradual failure in the supply of thyroid secretion which led to the disappearance of the symptoms of the former disease, as it did to the production of those of the latter at a later period ? Dr. Byrom Bramwell14 has clearly pointed out the striking contrast which exists between some symptoms of exoph- thalmic goitre and those of myxoedema This is what should be expected if the former are due to an excessive supply of thyroid secretion, an exactly opposite condition to that which obtains in myxcedema. This contrast is well shown when the symptoms are arranged in parallel columns. Exophthalmic Goitre. Hypertrophy of thyroid gland. Acceleration of pulse. Excessive perspiration. Electrical resistance of skin is diminished. Temperature normal or above normal. Excitable temperament. Myxoedema. Atrophy of thyroid gland. Slowing of pulse. Perspiration diminished or absent. Electrical resistance of skin is increased. Temperature subnormal. Stolid temperament. If further observations also tend to show that the various symptoms mentioned in this paper can be explained in the manner indicated, it will simplify the problem which still remains to be solved as to the causation of other symptoms *2 Loc. cit., p. 880 13 Brit. Med. Jour., Jan. 7th, 1893. I4 Edinburgh Medical Journal, May, 1893.