Clinical notes on Graves' disease / by Professor Grainger Stewart and G.A. Gibson.

  • Thomas Grainger Stewart
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Clinical notes on Graves' disease / by Professor Grainger Stewart and G.A. Gibson. 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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    mother died in childbed when 21 years old. He is an only child. He has been twice married. There were two children by his first marriage, a son and a daughter, the former of whom died of some inflammation of the mouth, and the latter of smallpox. He has also two children by the second marriage, a boy and a girl, both of whom are well. His previous health has been good, except that during a service of fourteen years in the army he had ague when in India, and that he was mvalided in consequence of a splinter of a ball injuring the left eye. The present symptoms began three years ago, and have persisted since that time. The tongue is raw. The liver is rather larger than the normal, measuring 6 in. in the mammillary line. The isthmus of the thyroid is enlarged, and the lobes also, but not to such a great extent. There is faint pulsation, and a soft systolic murmur. The pulse, about 95 per minute, is very irregular, small, and of low but variable tension. The apex beat is in the fifth space, 4 in. from mid-sternum. The right border of the heart is 2:^ in., and the left, 3| in. from the middle line. There is a soft systolic murmur at the apex, and another soft systolic murmur in the tricuspid area. A harsh murmur, systolic in rhythm, is heard over the manubrium. There was some pleuritic friction over the lower lobe of the left lung when he was admitted. The urme varies from 70 to 80 oz., and has a trace of albumen. The j)atient x^erspires ]3rofusely, and has scanty hair on the scalp, in the axillae, and in the pubic region. The eyes are slightly prominent. There is delayed move- ment of the eyelids. The right pupil sometimes shows the Argyll Robertson phenomenon, at other times it does not. The left is immobile from the result of the accident. There is a distinct muscular tremor over the whole body. The knee jerks are almost abolished. The patient cannot stand with his feet together and the eyes closed. The patient is still in hospital, but has greatly improved in health under the use of digitalis and iron.