BASEDOW S DISEASE 



It has been pointed out that the multiplicity of the Basedow's symptoms 

 cannot well be explained by the functional increase of the thyroid gland 

 alone, and that therefore also on this ground a qualitative alteration of the 

 secretion must be supposed. This objection does not hold in this general 

 interpretation. All the symptoms of Basedow's disease may be produced, 

 at least in miniature, after the administration of normal thyroid gland. 

 What syndrome will develop all depends on the constitution of the affected 

 individual (Falta, Newburgh, and Nobel). 



Objections have been raised to point 4. It is true that in the most 

 cases we observe under thyroid medication distinct aggravation of the 

 Basedow's symptoms, such as increase of the tachycardia, arrhythmia, 

 sleeplessness, excitement, profuse sweats, gastrointestinal disturbances, 

 severe prostration, etc. But there have been reported cases in which 

 the thyroid medication acted favorably. Quite complicated theories have 

 been advanced for the explanation of these cases; thus, for example, Mb'bius 

 believes that the increased activity of the thyroid gland retrogresses if 

 through the administration of thyroid glandular substance the gland is given 

 time to recover itself. Such cases may be explained without overdrawing 

 by the observation that in many cured cases of Basedow's disease the 

 counter-regulations develop strongly. I previously mentioned a case in 

 which, after the cure of the Basedow's, thyroid-gland tablets even in large 

 quantities would bring forth no distinct relief. If, therefore, thyroid medica- 

 tion takes place in the declining stage of the disease, slight favorable results 

 may be readily induced. 



The most important point is point i, the opposition in the symptom 

 picture of Basedow's disease and of myxedema. I here reproduce the ex- 

 cellent table of Kocher: 



Cachexia Thyreopriva 

 Absence or atrophy of the thyroid 

 gland. 



Slow, small, regular pulse. 



On application of cold to the skin, all 

 vasomotor changes are absent. 



Listless quiet gaze without expression 

 and animation. 



Narrow palpebral fissures. 



Retarded digestion and excretion, 

 poor appetite, few demands. 



Slowed metabolism. 



Thick, nontransparent, folded, dry to 

 scaly skin. 



Short, thick fingers often broadened 

 at the ends. 



Sleepiness and tendency to sleep. 



Morbus Basedowi 



Swelling of the thyroid gland mostly 

 of a diffuse nature, hypervascularization. 



Frequent, often tense, rapid, now and 

 then irregular, pulse. 



Extraordinarily irritable vascular nerv- 

 ous system. 



Anxious, unsteady gaze which is choleric 

 on fixation. 



Wide palpebral fissures, exophthalmus. 



Abundant evacuations, mostly abnormal 

 appetite, increased demands. 



Increased metabolism. 



Thin, transparent, finely injected, moist 

 skin. 



Long, slender fingers with pointed end 

 phalanges. 



Sleeplessness and disturbed sleep. 



