On myxoedema and allied disorders : being the Bradshaw lecture delivered at the Royal College of Physicians, on November 10th, 1898 / by William M. Ord.
- Ord, William M. (William Miller), 1834-1902.
- Date:
- [1898]
Licence: Public Domain Mark
Credit: On myxoedema and allied disorders : being the Bradshaw lecture delivered at the Royal College of Physicians, on November 10th, 1898 / by William M. 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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![intervals, and without taking ap])arent notice of a remark or question intended to break the prolonged monologue. In connection with speech, it must be remarked that the patients in many cases write letters, also at great length, and that as a rule the handwriting is good and monotonously regular, the difficulties already mentioned in respect of the movements of the fingers not appearing to interfere with the use of pen or pencil. The voice, which I have tried to describe, with its monotonous flow and leathery intonation is, once heard, almost in itself a ground for diagnosis of the whole disease. It has occurred to me to hear a patient speak outside the door of my consulting room and to recognise the disease before I had actually seen the subject. It has occurred also under my observation that patients in hospital under treatment for myxcedema would detect in the voice of a newcomer the existence of the malady and would say, “ That’s my disease.” The imperfections in speech are not always so com- plete as in the typical cases which I have already described. It sometimes happens that the elocution is only comparatively slow, and the existence of a difficulty is not fully understood only after treatment. Then it is frequently found that the patient naturally speaks very quickly and with excellent elocution, which has only been modified in a minor degree. It is, of course, obvious that not infrequently the loss of teeth complicates matters and increases the difficulty of articulation. If the treatment of myxoedema in any case be successful, natural speech is gradually resumed, but while the mechanical obstacles appear to pass away completely, the tendency to garrulity for the most part persists ; so that the physician has still to listen to a long setting forth of comparatively small matters recited volubly and with interminable iteration. That the state of the nervous system is much concerned in tins alteration of speech is, I think, abundantly clear. It is perhaps only the first to attract our notice of many nervous syuqjtoms. In some cases, to the difficulty of speaking, a difficulty in swallow- ing is added. The swollen state of the fauces and of the mucous membrane beyond would make us ready to expect some difficulty, hut at times dysphagia of considerable severity together with affection of inspiration, will lead to a suspicion of affection of the medulla oblongata. It has been noted already that the aspect of the patients is lethargic. A considerable number are actually lethargic and](https://iiif.wellcomecollection.org/image/b22416249_0014.jp2/full/800%2C/0/default.jpg)
