Nine cases of Graves' disease: ophthalmoplegia : remarks on the lid-symptoms / by Arthur Maude.

  • Maude, Arthur.
Date:
[1892?]
Catalogue details

Licence: Public Domain Mark

Credit: Nine cases of Graves' disease: ophthalmoplegia : remarks on the lid-symptoms / by Arthur Maude. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    aii<l occasional otonhoea from tlie left ear. Tlie tonsils liave been enlarged for KOine moutlis. Marcli 20, 1891-—Slie now comes to be treated for llie otorrlioea. Tliere is much purulent discharge from left ear; membrane thickened, depressed, with large jierfoiation. She is a fat, flabby girl, very nervous and hysterical in manner, abrupt and excitable in her answers, slight deafness of bolh sides, much hypertrojdiy of tonsils. Thyroid uniform, Kymiuetriciil enlargement. No cardiac bruit. Pulse 130, regular. The eye- lids swollen in appearance. Giafe's sign absent. Slight tremor of hands. The tremor has been very mnrked, so as almost to prevent her writing. No sweats. No diarihoea. During the last two months she has had two attacks of vomiting. She is very nervous, easily startled, and very irritable with her pupils. April 21.—Distinct ])roptosis. This has been noticed from time to time during the Inst month. The jiulse continued very rapid (120-150) whenever I saw her. She improved rapidly under large doses of belladonna. Casr III.—Miss , born 1848. No family history or pre- vious history of importance. Had always had good heiilth till 1882, when she was noticed to be getting thin, and proptosis was observed by a relative, a doctor. Slie saw Dr. Wilks in Miiy 1882, who kindly writes to nie that he (bund ' her thin, with palpitation of the heart, the number of beats averaging 150; she often broke out in pers])iration. There was no thyroid enlargement, but a doubtful tendency to prominetice of the eye- balls; kidneys healthy ; appetite good, often very hungr}'. After sitting down for some time the jtuLse went down 20 beats. I regarded the case as one of exoi)hthalmic goitre without exoph- thalmos and goitre. Dr. Wilks gave her a course of belladonna, and she rapidly improved. In fact, she was regarded by her usual medical atteiulant as quite well in March iSSj.^ I have kept watch over her for years. She contiimed in fair health for nearly ten years—in fact, improved ; but she remained in a condition of fruste Graves' disease. Her principal symp- toms were: A great mental restlessness; she was always wanting to do something, and made a great deal of the smallest trifles; her family used to say of lier that she was always fashing (Scotch for bothering) herself. At one time she showed a completely morbid sense of duty. She also hiid an extreme restlessness of the hands and feet. They were never still; she was always playing with her watch-chaui »'> dress, or tlie corners of her nmulh, and there were constant irregular, almost choreic, movements of the facial muscles—syni-