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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    Case V.—Miss A., born 1847, sister of the preceding patient. Has had a large goitre. Since it first appeared there has cer- tainly been proptosis; a photograph taken in 1876 shows it well. She has never had definite rheumatism, but had bad growing pains when a child. The only remarkable feature in her case is that in 1882 she was treated by a well-known throat specialist^ for the goiire with injections of iodine into the thyroid and hydrofluoric acid internally. The treatment was prolonged, and there was great reduction in the size of the gland, and from that t inie her general health imj)roved very greatly. Slie used to suffer much from fatigue and feebleness, but now (May 1891) she regards herself as quite well and strong, though she has still a large goitre and very distinct proptosis, and she still has periodic attacks of sickness, lasting three or four days. Case VI.—Mrs. E., born 1866. Rheumatic family history; ])atient herself had rheumatic pains some years ago. A brother was subject to fits from five to thirteen years of age. A sister was noticed by Dr. Hector Mackenzie to have very prominent eyes. Her only baby had an intra-ocular glioma. Her illness commenced with a sudden attack of diarrhoea in April 1889, accompanied by slight prolapse of the uterus and distinct recto- caele. She had had her only labour in August 1888 ; there was no rupture of perineum. I first noticed a gditre in July 1889. There was much ])alpitation. The eyes were normal then. Slie luis become very thin. In 1887 she used to have frequent attacks of epistaxis, so severe that she described them as flooding from the nose. In December 1890 she began to have frequent attacks of vomiting, at intervals of about a week. This vomiting has 110 relation to the digestion of food, and is frequently accompanied by hsematemesi.s, the blood being arterial blood in small quanti- ties mixed with the fluid contents of the stomach. She is never comfortable without a pessary of some sort. If it is taken out, she has a sense of bearing down and local pain and the palpita- tion increases, generally followed by an atliick of sickness._ I find the vaginal walls and perineum extremely thinned, feehng like some fine textile fabi ic. The uterus is small and heidtliy. The menses regular in time and quantity since the weaning of her baby. She has all the typical signs of Graves' disease—goiire, pro- 1 I have written to tbia gentleman to ask for information about the ciiae, biit he vouchsafes no reply ; so I am dependent on the atiitements of niy patient, which can, however, be accepted.