Clinical lecture on myxoedema / by William Ord.

  • Ord, William M. (William Miller), 1834-1902.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lecture on myxoedema / by William Ord. 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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    may be expected to be followed by an increasing torpor of the centres, just as a paralysed limb wastes for want of exercise. And so one would expect the slowness in voluntary movements and the slowness in thought to follow the first sense of mere heaviness or sluggishness. In more advanced cases than these before you, the increase of lethargy becomes most distressing. The day is spent in overtaking the duties which ought to have been over in the first hour of it. The muscular errors become so marked that frequent falls occur. One lady under my observation broke both ligamenta patella; in succession, owing to the wide separation of the action of flexors and extensors, the latter contracting, during a fall produced by this want of punc- tuality, just in time to cause the fracture. The same patient habitually walked in a singular tottering way, quivering from head to foot as each step was taken. Her head hung on her chest, in consequence of the incapacity of the will to maintain muscular action, and the thick blubber lips, swollen eyelids, and dribbling saliva completed a very cretin-like picture indeed. In relation to muscular movements, any padding of muscular nerves would be likely to cause slowness of transmission of impressions of contractions, and so make the first step in the failure of co- ordination. The two cases which I have followed to a fatal termination, the one after eight years, the other after five years of observation, both ended by way of renal disease. In one, a post mortem examination was made, as already noted. The kidneys here shared the condition of the skin. There was enormous interstitial growth of connective tissue of this soft gelatinous kind by which the secretory tissue was compressed and the early stage of granular kidney in part imitated. The same in- vasion had occurred in other organs, notably in the liver and heart; but I could not satisfy myself of the existence of the same or any parallel condition in the central organs of the nervous system. Speci- mens of skin from various parts, of kidneys, liver, heart, brain, and cord, are here under the microscope. Reviewing the cases which have been under my notice, I may state that all were women of adult age : some married, some not. Of the married, some had children even after the dropsical condition had been well developed; there was not any known taint of syphilis in any, nor any general history of excess in food or stimulants. All shared the state of skin and the characteristic face, the absence of albuminuria, the slowness of perception, thought, and action, particularly of speech.