70 ENDOCRINE GLANDS 



2. NERVOUS DISTURBANCES. These patients com- 

 plain of a sensation of fatigue in the morning, and only 

 begin to feel normal after having been up for several hours. 

 They complain of frontal or occipital headaches, muscular 

 and articular pains, vaguely called neuralgias and of indefi- 

 nite etiology. In some there is a decrease of the memory and 

 of physical activity, resembling neurasthenia or psychas- 

 thenia. Others need considerable sleep and doze off after 

 each meal. Some have a marked intellectual apathy. 



3. EDEMA. White, firm, indolent edema, independent 

 of all cardiac or renal affection, occurring on the face 

 (forehead, eyelids). Some women at the time of men- 

 struation have a temporary swelling of the hands and 

 feet and can only remove their rings with difficulty. 



4. DIGESTIVE DISORDERS. Outside of anorexia, a 

 common symptom, there is often, in women, a persistent 

 constipation with or without muco-membranous colitis. 



5. PILIARY DISTURBANCES. Early baldness, alopecia, 

 associated with rarefication of the hairs of the outer part 

 of the eyebrows are stigma of thyroid insufficiency. 



Cases of hypothyroidism are predisposed to a variety 

 of morbid disturbances. 



Respiratory infections are frequent in these patients 

 which often have hypertrophic tonsils, a red pharynx, 

 retracted nasal fossea, due to thickening of the mucosa. 

 They are subject to repeated sneezing (Hertoghe) to 

 sore throat, colds in the head and bronchitis. Asthma, of 

 nasal origin is often remarkably improved by thyroid 

 organo therapy. 



Menstrual disturbances are nearly constant and show 

 themselves at the time of the periods by real hemorrhages, 

 others have painful menstruation accompanied by head- 

 ache or excessive nervous irritability. 



The attacks of migraine also come on between the 



