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

  • Maude, Arthur.
Date:
[1892?]
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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)

    9/16 (page 141)
    On compiiriiig l.lie dclails of lliese Ciises, we find Uiat diarrhoea was present in four (VL, VIT., Vllf., IX.). If, presented the cimraclerso typical in Graves' disease, and described recently by the writer.i |'The diarrhoea is paroxysmal, so paroxysinal'that Charcot has likened it lo the gastric crises of locomotor ataxy. The bowels are quite natural and regidar perhaps for some weeks, and then snddeidy, at any time of day, but usually in the early morning, and with no apparent cause, the patient has Hii urgent call to the closet, and passes wiihout pain or colic a huge liquid motion. The motions are serous and generally light- coloured. Tiiere are three or four motions of the same characler each twenty-four hours for several days, and then Ihe atlack ceases as suddenly as it began, and there is an inlerval perhaps for a few days, weeks, or even months. In severe cases I have known as many as fifteen or eighleen actions lo take place in the day. The recurrence of these attacks is curiously regular in some case.s. There is not necessarily any accompanynig sick- ness, but the two do sometimes coincide. The longuels not afiected, and the appetile is not only unimpaired, bid, may be- come ravenous. Naturally the prosiration produced by these fttlacks IS very great, but I can fiiul no record of u death dn-ectly caused by the diarrhoea.^ When an inlestinal crisis coincides wiih a rise of temperature such as IS common m the disease, the occurrence of acute intestinal' catarrh may be wrongly suspected, and the accompanying tem- GllTiu^^e:- ^1''^™''^'-' ^95, Crises of the Digestive Let in * [Eva E. M'D., set. 25, single, was .a<lnntted to Sh. Bartholomew's Hospital under u>y care on Jnly 9 1891, having for three n.onths been under thf care o a doctor suffering f ron. shortness of breath. She considered that she had oeen .n good heaUh up to that tune, and had not noticed any change in her neck or eyes. A week before her admission she had a very serious atl.ck of diarrhoea and vo>m mgLasting three days. The catamenia had been irregular for thr^e years. On ad.nus.on it wa« noted that she was a highly neurotic, delicate^ looking woman, dark-brown hair and eyes, eyes promi-.^.^: eyelids pigmented o„d systolic mnriniir of varying intensity, conducted nto the vesse s The thyroid was much enlarged, .narked arterial pulsation; a good deal of brown nEi „ with unpigmented areas in'its fnidstrB mi ar pi ment.-vt.on over the chest and abdomen and in the axillae. The u i.,e was of fn average sp. gr. of 1016 whilst she lived, and alw.iys had in it a fa nf rV. t fZri. a week she went on fairi; well, but'oVj^^y'' 6 l?d ^^^^^^^^^^ o™i ^r'l ''^^ ^« with difficulty. VmniS ..ecu red at frequent ...tervals afr.er this, and on August I .lianhi set Z! edla^rhL^rtlurng': examination nothing was found explaini..^ nr-^Ji^ ff T' ^ y The wonmn, wlio Lad im- vI^rTl • T- ^^^''^^•■^ 'fkthe Jfospital, and lived for near y w, years, bemg subject to severe attacks of diarrhcra and died r,, far „= T „ 1 1 1 out from her friends, of asthenia produced byTh;.;. W S C.^Edito;:]