DUCTLESS GLANDS 537 



titled to the credit of the original and classical account of the disease, 

 although he did not, as the French say, afficher, that is advertise, his 

 discovery by attempting to label it. 



In 1833, Flajani published his account of the disease, in which he 

 recognized two of the cardinal symptoms, the goiter and the cardiac 

 palpitation. In discussing palpitation of the heart at the Meath Hos- 

 pital in 1835, Eobert Graves, the Dublin clinician, published his classical 

 description of exophthalmic goiter, in which the exophthalmic feature 

 was noted. He records that, in one patient, the beating of the heart 

 could be heard at least four feet from her chest. After the time of 

 Graves and Basedow, many similar observations were collected by 

 clinicians, but it was not until the year 1886 that the condition was 

 attributed to an excessive outpouring of the thyroidal secretion by the 

 German neurologist. Mobius, 10 who at the same time, described a 

 number of related symptom-groups which he regarded as due to quali- 

 tative or quantitative changes in the secretion itself ("dysthyroidism"). 

 In connection with the cretins observed by Paracelsus around Salzburg, 

 it is of record that Curling, an English pathologist, first observed that 

 absence of the thyroid body is accompanied by "symmetrical swellings 

 of fat tissue at the sides of the neck, connected with defective cerebral 

 development" (1850). The classical account of this condition is due 

 to Sir William Gull (1873) and it was called myxcedema hy William 

 M. Ord, of London, in 1877. 



It is a curious fact that the same volume of the journal in which 

 Basedow published his account of exophthalmic goiter contains an 

 observation by Benhard Mohr, 11 a privat docent at Wurtzburg, of a 

 remarkable and fatal obesity in an elderly gardener's wife, attended by 

 incipient imbecility (lappisches und Jcindisclies Benelimen), loss of 

 memory, general somnolence and scotoma, which, coming to autopsy, 

 revealed a tumor-like degeneration of the pituitary body produced by 

 inmixture and copious effusion of a serous fluid, the discharge of which 

 had induced pressure phenomena in reference to the adjacent parts of 

 the brain. This was the first recorded case of what is now known as 

 pituitary obesity (1840), the "dystrophia adiposo-genitalis " of Froh- 

 lich and Bartels. 



In spite of the amount of original clinical delineation already on 

 record in the first half of the nineteenth century, these lesions of the 

 ductless glands attracted little attention. More interest was excited 

 by the appearance, in 1855, of what we must now regard as the principal 

 milestone in the history of the subject, the monograph "On the Con- 

 stitutional and Local Effects of Disease of the Supra-renal Capsules," 

 a quarto of 43 pages by Thomas Addison, senior physicion to Guy's 



io Mobius, Schmidt's Jahrb., Leipzig, 1886, OCX., 237. 



11 Mohr, Wochenschr. f. d. ges. HeilJc., Berlin, 1840, VI., 565-571. 



vol lxxxv. — 37. 



