Bulbar lesions in Graves' Disease : a contribution to the morbid anatomy of exophthalmic goitre / by Sir Thomas Grainger Stewart and G. A. Gibson.

  • Gibson George Alexander, 1854-1913.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Bulbar lesions in Graves' Disease : a contribution to the morbid anatomy of exophthalmic goitre / by Sir Thomas Grainger Stewart and G. A. Gibson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    toms of Graves’ disease, which disappeared gradually as the effects of the lesion passed away. It appears to us that this positive observation is of greater value than any other which lias been hitherto recorded. Several instances of organic lesions of the nerve centres in this disease have been carefully described. Geigel found in one case obliteration of the central canal of the medulla, with hardness of the nerve substance around the canal, pro- liferation of the neuroglia, and turgescence of the vessels; there was also a tumour of the spheno-occipital synchondrosis. In a case recorded by Mackenzie, Lockhart Clarke found softening of the corpora quadrigemina and medulla oblongata especially on the posterior aspect. Cheadle described dilata- tion of vessels and luemorrhage in the medulla oblongata and cervical part of the spinal cord, along with shrinking of the cells, and Hale White found haemorrhages into the aqueduct of Sylvius and the posterior aspect of the bulb as far as the restiform bodies. Some of these observations are discussed in the well-known work of Long Fox, and others in the mono- graph by Mannheim, which 1ms already been mentioned. In two cases which have come under our immediate observation, definite lesions were discovered in the central nervous structures. Both were extremely well-marked examples of Graves’ disease. In the first of these patients, in addition to all the usual clinical characteristics, there was hyperpyrexia, speedily followed by death. The second, full details of which were published by us in the paper referred to, died of cardiac failure, accompanied by severe anginous attacks. The following is the description of the post-mortem examination of the first case, which was performed by Ur. Barrett:— Exophthalmic Goitre, Cardiac Dilatation, and Failure. —Ward 25. Louisa T., set. 37; died 29th March 1891; post-mortem, 31st March 1891. External appearances.—Fleight, 6 0 in.; circumference, 3 0 in. (Edema of feet, right hand, and left fingers. Kigor absent. Lividity marked on dorsum; scattered on neck and over thorax; arterial in colour. Icteric tinge of abdomen,
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