Graves's disease / by Arthur Maude.

  • Maude, Arthur.
Date:
[1894]
Catalogue details

Licence: Public Domain Mark

Credit: Graves's disease / by Arthur Maude. 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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    [ Reprinted from the ‘ Transactions of the Medical Society of Londonvol. xvii.~\ / & ^f)f- GRAVES’S DISEASE. By Arthur Maude. Mr. President and Gentlemen,—I propose to touch on certain points in exophthalmic goitre or Graves’s disease. The first is the importance of the thyroid enlargement. The belief is an established one, that the disease may exist (and frequently does) without any goitre, and there are plenty of statistics of the proportion of cases in which goitre occurs. Having for some years taken great interest in this condition, I have had a routine custom of always examining the thyroid in all cases of anemia or cardiac disturbance at every interview. The result has been that I have detected several cases of Graves’s disease in an early stage, and my diagnosis has been verified by the onset of other marked symptoms pertaining to that condition. I have had 15 cases under my care in the last five years : it is not a large number, but the conditions of my work have enabled me to watch them more closely and for a longer period than, probably, any other series of cases has ever been watched, for it is impossible in hospital or consulting practice to follow patients as I have done. My observation is a positive one, and therefore worth many nega- tives, that every person has presented variations in the size of the thyroid from the earliest complaints of any cardiac symptoms. This variation has been in several very slight at first, no more than many women show, if the neck is carefully examined, when in per- fectly good health. I prefer, therefore, to call it a “ variation in the size of the thyroid ” than a goitre. However, in all these 15 cases, if a large goitre was not present at first it developed later. All my patients have been women. One case I have watched with peculiar care—seeing her con- b