Observations and experiments on the pathology of Graves's disease / by Walter Edmunds.

  • Edmunds, Walter.
Date:
[1895]
Catalogue details

Licence: Public Domain Mark

Credit: Observations and experiments on the pathology of Graves's disease / by Walter Edmunds. 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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    uuder his care of ten years' standing, in which a considerable portion of the goitre was excised in the hope of benefiting the exophthalmos, which was extreme: the patient was not improved, certainly not in the exophthalmos. The fact that the eye symptoms of G-raves's disease can be pro- duced by a chemical poison (cocaine) may be held to support the Tiew that a poison secreted by the thyroid might do the same. The effects of cocaine in this connection were first pointed out by Keller, and have since been carefully studied by Jessop; the latter found that by dropping cocaine into the eye there was produced (1) proptosis, (2) absence of winking, (3) Graefe's sign, (4) local anesthesia, (5) dilatation of pupil, (6) widening of the palpebral fissure, (7) paralysis of accommodation, (8) diminution of ocular tension. In a case of complete facial paralysis cocaine still caused widening of the palpebral fissure, and he argues that the cocaine must act on the unstriped muscular fibres (which are supplied by the sym- pathetic). His experiments also show that stimulation of the sympathetic in the neck could further dilate a pupil already as ftilly dilated as atropine could make it; and that cocaine could also dilate a pupil fxilly dilated with atropine. In a case of Graves's disease he found that cocaine administered cautiously produced in- creased proptosis, further dilatation of palpebral fissure, and halting in the descent of the upper eyelid. Jessop also found that in the rabbit, if the cervical sympathetic be divided, after a few days cocaine will not produce dilatation of pupil, nor proj>tosis, nor widening of the palpebral fissure. The effects of cocaine injected subcutaneously in monkeys, both with and without division of the cervical sympathetic, have been tried by myself. The results in monkeys of division and stimulation of the cervical sympathetic are described by Sherrington in the ' Journal of Physiology,' and represented in the figure here repro- duced. Divmon of cervical sympathetic causes (1) recession of eyeball; (2) contraction of pupil; (3) narrowing of palpebral fissure; (4) (edema and flushing of skin round eye; (5) swelling of caruncle; (6) projection of pinna from side of head; (7) puckering of skin of niTizzle; (8) flattening of certain hairs on forehead, which cannot then be elevated by the emotions which will raise the correspond- ing hairs on the opposite (normal) side of the head,