BASEDOW'S DISEASE 6l 



favors the increased output of secretion and thus a circulus vitosus is es- 

 tablished. Perhaps also a secondary increase of the activity of the chrom- 

 affin tissue or a greater sensitivity to adrenalin of the organs supplied by 

 sympathetic nerves is associated with the cardiovascular symptoms (tachy- 

 cardia). The facts are that on the simultaneous administration of thyroid- 

 gland secretion and adrenalin, action pulses may also be produced in animals 

 (Kraus and Friedenthal] ; v. Cyan attributes to a simultaneous irritation of the 

 vagus and sympathetic, and to the fact that, according to Asher and Flack, 

 the thyroid-gland secretion may increase the activity of adrenalin. 



The eye symptoms may be expressed in different degrees of intensity. 

 Often there is only a slightly heightened glitter of the eye, the alterations 



FIG. 6. Gaping of the palpebral fissures in Basedow's disease. 



showing only on very exact examination; in other cases occur those strik- 

 ing alterations that Mobius compares with those of the facial expression of 

 intensest terror. 



As an example I shall quote the following case: 



Observation I. Anna K., twenty-six years old. For about two months cardiac pal- 

 pitations, conditions of excitement, pains in the cardiac region, sweats, tremor, and en- 

 largement of the neck. 



The increased width of the palpebral fissures is evident. Protrusion slight, rare blink- 

 ing, thyroid diffusely enlarged, weakly elastic vascular murmurs, tachycardia up to 361 

 [sic.], 1 blood pressure (Riva-Roccd) 100. Increase of temperature up to 37.7 C., 

 alimentary glycosuria negative. 



*36i in the German edition probably an error for 136. Editor. 



