A contribution to the clinical study of exophthalmic goitre / by William Pepper.

  • Pepper William, 1843-1898.
Date:
[1879]
Catalogue details

Licence: Public Domain Mark

Credit: A contribution to the clinical study of exophthalmic goitre / by William Pepper. 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.

    1/20
    of the Author. [Extracted from the Transactions of State of Pennsylvania. Yol. edical Society of the XII. 1879.] A CONTRIBUTION TO THE CLINICAL STUDY OF EXOPHTHALMIC GOITRE. By WILLIAM PEPPER, A.M., M.D., PROF. OF CLINICAL MEDICINE IN THE UNIVERSITY OF PENNSYLVANIA. Many names have been applied to the peculiar condition of dis- ease characterized by rapid action of the heart, protrusion of the eyeballs, and enlargement of the tigroid gland. Most of them are open to the objection of not indicating definite^ either the princi- pal symptoms, or the essential character of the affection. It is on this account that I much prefer the name “Exophthalmic Goitre” to either that of Graves’ disease, or of Basedow’s disease, by one or the other of which it is most commonly described. Exophthalmic goitre is not a distinct and specific disease in the sense that typhoid fever and acute croupous pneumonia are, but still it has a perfectly well-established claim to its place in our nosology. It is true that in well-marked cases there are certain features which are dependent on the anaemia which is so frequently present, and others which are due to the general neurasthenia that is usually attendant. But apart from these, there is the clearly defined group of symptoms first mentioned, which are so peculiar and so constantly associated in this disease as to clearly establish its separate identity, and to show that it is connected with some special morbid condition. A good idea of the cause of exophthal- mic goitre in its aggravated form may be gathered from the follow- ing history. Case I.—R. T., a tall, spare woman of nervous temperament, when about 27 years of age, suffered a severe disappointment in a love affair. Soon afterwards she began to present symptoms of im- paired nutrition, loss of color, emaciation, debility, etc. She became much more highly nervous and excitable. At the same time the action of the heart became rapid and excited, and the thyroid gland enlarged. There was marked irregularity of menstruation. There was a marked ansemic bellows murmur over the base of the heart. The carotid arteries pulsated violently, and were the seat of a strong