80 ENDOCRINE GLANDS 



When paralysis occurs, it usually is localized to the legs 

 and at the beginning shows the characteristic of a para- 

 plegic functional paralysis with sudden onset and with the 

 retention of the reflexes and integrity of the sphincters 

 (Paraplegia of Basedow's disease described by Charcot). 



b. Sensory disturbances. These vary; neuralgia in 

 various localities (cervical, occipital and especially facial) 

 or arthralgia simulating rheumatism. 



c. Secretory and vaso motor disturbances. These are 

 very common and very important; waves of heat, profuse 

 sweating, generalized or localized to the neck, trunk, 

 arms, etc; sensation of abnormal heat or thermophobia. 

 The patients place themselves in a draft or sleep without 

 any bed clothes in winter. 



d. Dystrophic disturbances. These are present in 

 certain subjects. In some cases there is a melanodermia 

 resembling Addison's disease, vitiligo, brown spots, 

 edemas characterized by a thickening of the skin at the 

 level of the neck and buttocks. 



e. Psychic disturbances are nearly always present. 



Changes in character become more pronounced as the 

 disease evolves. The patients are impatient, emotional, 

 irascible; one minute sad, the other cheerful and become 

 very unsociable because of their change of humor. In 

 predisposed individuals these changes may result in a 

 true psychosis, melancholia, mania, with hallucinations, 

 or persecution, etc. Insomnia is frequent. This can be 

 opposed to the sleepiness of myxedematous patients. 



2. GASTRO INTESTINAL DISTURBANCES. 



The appetite varies, sometimes increased, at others 

 decreased. The digestive functions may be normal. Occa- 

 sionally, patients with Basedow's disease have gastro 

 intestinal crises, beginning and ending very suddenly 



