Select clinical cases : including cases of labio-glosso-laryngeal paralysis, exophthalmic goitre, arterial pyaemia, general chronic arteritis, saturnine gout / by Samuel Wilks.

  • Samuel Wilks
Date:
[1870]
Catalogue details

Licence: Public Domain Mark

Credit: Select clinical cases : including cases of labio-glosso-laryngeal paralysis, exophthalmic goitre, arterial pyaemia, general chronic arteritis, saturnine gout / by Samuel Wilks. 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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    The thyroid, which is of so great a size during life, has been found in some cases simply hypertrophied, in other cases merely enlarged from an increase in the number and size of the blood-vessels. In the same way the eyeballs have become pro- minent, from the surrounding fat and cellular tissue containing more blood; but in some very chronic cases it has been asserted that there has been a production of new connective- tissue. Virchow has some remarks on this disease in his work on tumours, and in the first place discusses the question as to the priority of its alleged discoverers. He would not with Trousseau style it Graves’ disease, thinking that the Germans have an equal right to call it Basedow’s disease. Virchow himself styles it “struma exophthalmica,” and refers to Lebert’s scientific title of ‘ Tachycardia strumosa.’ It may be said that there are authors who claim priority of discoveiy for Dr. Stokes and Dr. Begbie. In reference to the condition of the organs, Virchow states that the enlargement of the thyroid is due mainly to an enlargement of blood-vessels, especially of the veins, but that it may go on to a fibrous induration. In nearly all cases he found the heart enlarged, the left ventricle being dilated, but the valves sound. As regards tlie eyes, the prominence is due to a change in the fatty tissues of the orbit, which may be hypertrophied, but generally the orbital structures are merely in a hyperaemic condition. The fact that such a remarkable combination of symptoms is repeatedly met with, is sufficient to show that there is some special derangement of the animal machinery, and various have been the theories to account for it. There are those who have been content to attribute the,whole of the symptoms to ansemia ; and this supposition has been supported by the fact, that the complaint is frequently met with in yormg girls who are suffering from chlorosis. Constantly a patient who at first sight has simply this malady, is found, besides the palpitation of the heart and throbbing in the vessels, to have some enlargement of the thyroid and prominence of eyeballs. Others have thought that a primary affection of the heart might cause the complaint, and no doubt in many cases as a part of the general congestion, there is great fulness of the blood-vessels, promi- nence of eyeballs, and enlargement of the neck. Such cases
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