BASEDOW'S DISEASE 65 



gen, that is, with the need for rapid loss of heat on account of the increased 

 heat production. Bryson's sign the patients are not able to expand the 

 chest in the normal manner on deep inspiration of the thorax has nothing 

 to do with this, but depends apparently on a weakened condition of the 

 respiratory muscles as a result of the fatty degeneration that was found by 

 Askanazy in all the bodily musculature. The acceleration and becoming 

 shallower of the respiration was also produced experimentally by Fenyvessy 

 by the feeding of the thyroid gland substance to dogs. It was absent after 

 cutting of the vagus nerves. The graphic registration of this breathing 



FIG. 8. Absence of the eye symptoms in Basedow's disease. 



in Basedow's disease shows very clearly the shallowing of the respiratory 

 efforts and the periodic cessation of respiration (increased tonus of the vagus, 

 Hofbauer). Eppinger and Hess have observed these respiratory curves, es- 

 pecially in those Basedow patients who showed signs of increased tonus in 

 other autonomous nerves. 



To the nervous symptoms belong almost all the symptoms of Basedow's, 

 as they are for the most part the expression of the condition of irritation 

 of the vegetative nervous system. Of the nervous symptoms in the narrower 

 sense is especially to be mentioned the tremor of the separated fingers, which 

 was first observed in 1862 by^Charcot and was later described by Marie in a 

 monograph as the principal and initial symptom of Basedow's disease. 

 Nothnagel has especially pointed out that the tremor is very fine. The 

 observations of A . Kocher give an idea as to the frequency [of occurrence] of 



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