88 THE DISEASES OF THE THYROID GLAND 



Cai-lu-xia Thyreopriva Morbus Basedmvi 



Retarded sensation, apperception, and Accelerated sensation, apperception, and 



action. action. 



'Deficiency of thoughts, listlessness, and Flight of thoughts, psychic excitement 



loss of emotivity. as far as hallucination, mania and melan- 



cholia. 



Awkwardness and clumsiness. Constant unrest and haste. 



Stiffness of the extremities. Trembling extremities, increased mo- 



bility of the joints. 



Remaining behind of bone growth Slender skeletal build, now and then 



bones short and thick, and often de- weak and thin bones, 

 formed. 



Constant feeling of cold. Unbearable sensation of heat. 



Retarded, heavy, breathing. Superficial breathing with deficient 



inspiratory expansion of the thorax. 



Increase of body weight. Reduction of body weight. 



Senile appearance, even when the Youthful luxuriant body development, 



patients are young. at least in the initial stages. 



A. Kocher distinguishes, in addition to these opposed symptoms, symptoms 

 that are similar in both diseases and reckons under these certain forms of 

 edema, dryness and becoming gray of the hair, pigmentations, and the 

 diminution of the secretion of the salivary and lachrymal glands that is ob- 

 served in many cases of Basedow's disease. One may add to these symp- 

 toms the dryness of the skin seen in rare cases of Basedow's disease and the 

 glycosuria of quite rare cases of myxedema. These "exceptions to the 

 rule" will hardly suffice to limit essentially the opposition in the symptom 

 picture of the two conditions. For the explanation of many of these ex- 

 ceptions, constitutional differences may be called into account; for example, 

 they may suffice for the explanation of the dryness of the hair and of the 

 skin, and for the diminution of the salivary secretion. Eppinger and Hess 

 regard the cause of the opposed behavior of the sweat formation in 

 different cases of Basedow's disease as a different tonus of the sympathetic 

 or of the autonomous nerves; surely such behavior does not furnish suf- 

 ficient argument against the hypothesis of hyperthyrosis, because also in 

 artificial hyperthyroidism we saw, in certain cases, a diminution of the 

 sweat formation under the influence of the thyroid medication. As far 

 as the behavior of the hair is concerned, in Basedow's disease the hair in- 

 deed may be dry but is also thin, while in myxedema it tends to be thick, 

 loose, and brittle. The explanation of other "similar" symptoms may 

 be attributed to the pathological correlations; for instance, the rare 

 glycosuria in myxedema may well point to a simultaneous insufficiency of 

 the pancreas. I would enter more fully only into a discussion of one of the 

 symptoms detailed, as it is regarded by the adherents of dysthyrosis as 

 an especially important argument. It is the combination of Basedow's 

 and myxedematous symptoms in the same patients. In Sattler's work 



