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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    with attiicks of semi-cataleptic nature (which I have witnessed). Ail Mrs. S.'s children, eight in nninber, are hypermetropic, one hoy having 4 D of hyperiuetropia, and another hoy has mild recnrrent mania. She is very hystei icnl herself. Mrs. S. had in 1887 limited plenro-pneninonia, and I thought I detected cavily signs in that Uing soon after. She had then severe hsenioptysis, and this has recnrred slightly ever since. I regarded her as phthisical, and in November 1888 she was an in-patient at Vic- toria Park. When there, a slight goitre was first noticed. It has ever since been very slight, and often disai)|»ears entirely. There has never been any proptosis, and the lids have moved always in a natnral manner. Tremor is very well marked, especially in the hands. It has existed for two years at least, is qnite typical in character, and at times so excessive as to incapacitate her for needlework or writing. Haemoptysis has occurred at short intervals ever since 1887. The blood coughed up is bright, fiuiil, and mixed with watery spntinn. The blood never clots, and there is never any sputum suggesting the presence of a cavity. I have failed to find any ])hysical signs of cavity or of consolidation in the lungs since 1888. She has frequent attacks of diarrhoea of a typical character, and has several times had liaBuiorrhage from tiie bowels. The diarrhoea is usually accompanied by sicknes.s. Only once has she vomited blood ; the vomit consisted of nearly half a pint of fluid blood mixed with gastric mucus. The thyroid increa.sed notably during the attack. The vomit was seen by me. PuLse rale rapid—100 to 150—very irregular and feeble. Gi'eat muscular weakness. Siie complains frequently of great pra^cordial pain, which radiates upwards to the neck, probably along the plexus of nerves up the great vessels. Sweating is often very profuse. I saw her once, during the last terrible winter, when she had not been able to have her bed-clothes changed in the morning, enclosed in a sheet stifTened witli ice formed of frozen sweat. Her mental condition is characteristic. She cannot trust her memory at all; if she tries to think of the simple matters which concern her (sewing or cooking, &c.), some other idea crops uj), ami she fails to carry out any little intention. Siio used to be a good sempstress, but now spoils all her work by culling out materials quite wrongly. Din ing the summer of 1S91 thermophobia became marked. This case is of great practical interest—a case of exophllialinic goitre witli little goitre and no ocular symptoms, but presenting ulmost every other known sign (except pigmentation).