THE THYROID APPARATUS 95 



CACHEXIA THYROPRIVA. GRAVES'S DISEASE. 



Retarded digestive and excre- Abundant excretion, generally 

 tory processes, small appe- abnormal appetite, in- 



tite, slight need for food. creased need for food. 



Slow metabolism. Increased metabolism. 



Thick, opaque skin, dry or Skin thin, transparent, finely 



scaly. injected, moist. 



Short, thick fingers, frequently Long, slender fingers, with 



broadened at the tips. pointed tips. 



Sleepiness and desire for sleep. Insomnia and restlessness dur- 

 ing sleep. 

 Retarded sensation, perception Intensified sensation, perception 



and action. and action. 



Mental vacancy and indiffer- Mental whirl, excitement to the 

 ence, lack of emotion. point of hallucination, 



mania, melancholy. 

 Awkwardness and slowness of Perpetual restlessness and 



movement. haste. 



Stiffness of the extremities. Tremor of the extremities, in- 



creased mobility of the 

 joints. 



Retarded skeletal growth, Slightly built skeleton, occa- 

 short, thick, frequently sionally soft or thin bones, 



deformed bones. 



Constant chilliness. Unbearable sensation of heat. 



Difficult and slow respiration. Superficial respiration, slight 



expansion of the thorax in 

 inspiration. 



Increase in weight. Loss of weight. 



Senile appearance, even of Youthful, luxuriant develop- 

 young people. ment, at least in the earlier 



stages. 



The antagonism between the principal symptoms of the two 

 conditions is very marked, though occasionally in severe cases of 

 Graves's disease symptoms appear which bear a close resemblance 

 to those of cachexia strumipriva. 



Other momenta, such as the deleterious effects of the exhibi- 

 tion of thyroid extract in Graves's disease and the artificial pro- 

 duction of the symptoms of Graves's disease by hyperthyroidism, 

 are to be regarded, not as direct proofs of the thyrogenic origin 

 of this condition, but as powerful arguments in its favour. 



We will now pass to a consideration of the symptoms and 

 organic changes characteristic of Graves's disease. 



The thyroid enlargement the goitre is one of the constant 

 symptoms of the condition. Cases where the thyroid changes are 

 absent are, in the opinion of all observers, extremely rare. The 



