Anaemia and its consequences: enlargement of the thyroid gland and eyeballs / [James Begbie].

  • James Begbie
Date:
1849
Catalogue details

Licence: Public Domain Mark

Credit: Anaemia and its consequences: enlargement of the thyroid gland and eyeballs / [James Begbie]. Source: Wellcome Collection.

    8/22 (page 4)
    pressed, the sensation of great distension. In one case the globe was so full and prominent, that when the patient slept her friends remarked that the eyelids did not cover the ball. Distrusting my own powers of diagnosis in a matter relating to the minute patho¬ logy of the eye, I requested my friend, Mr Walker, well known as an experienced oculist, to examine the subject of the second case, now in progress of recovery; he has kindly done so, and favoured me with the following statement regarding it:— u Both eyes are considerably more prominent than natural; the eye¬ lids, however, close completely over the globes, which Mrs M. says they did not do for some time. Vision is not at all impaired, nor is there any pain in the eyes, but often, she says, there is a feeling of distension. The corneas are of their natural size and shape; the anterior chambers are not larger than usual; the irides are lively and active; and the lenses are quite transparent. The sclerotic of both eyes is evidently distended from an increased secretion within ; they are larger than usual, have somewhat of a bluish colour a little anterior to the insertions of the recti muscles, although they do not seem to be thinned at that point; have a slightly flattened appear¬ ance, and do not present the usual globular shape that they do in the healthy eye. Both eyes are much harder than natural. There is no appearance of any morbid growth in the orbits—the globes can be pressed backwards as usual without causing any pain, and their movements are natural.” I.—In the autumn of 1839 my attention was called, for the first time, to the connexion of goitre and ana3mia in the case of a lady, aged thirty-two, one of a numerous and healthy family, which, with one exception, had grown up to manhood. She had married at the age of twenty-four, and continued to enjoy for many years a full share of health. She had no family, nor had ever been pregnant. For some years before I saw her she had suffered from continued mental anxieties and distress, and had laboured under profuse leu- corrhcea, by which her general health and appearance were much affected. For the last four or five months she had complained of in¬ ordinate pulsation of the heart, which was greatly increased by excite¬ ment, by going up stairs, by walking fast, by every thing, in fact, which hurried the circulation. At these times her face, which was otherwise pallid, flushed, and she became confused. The eyes pre¬ sented an unusual appearance, being prominent and staring, giving a wild and startled expression to the countenance ; a much larger share of the albuginea was seen than in the normal condition ; the membrane looked dark at a distance, and when examined near was found to be pervaded by vessels—many of these were also seen apparently in the sclerotic coat itself when examined through a lens; there was no dimness of vision, but a painful sense of distension of the eyeballs ; all this was increased on the occasion of palpitation, or when the face was flushed. Simultaneously with the appearance of