THE SYMPATHETIC SYSTEM 81 



and resembling tabes; ptyalism, gastric or abdominal 

 crises with vomiting and attacks of diarrhea, containing 

 mucus and bile and which exhaust the patient and are 

 followed by a marked loss of weight. 



3. RESPIRATORY DISTURBANCES. 



Outside of the rare cases in which a large goitre presses 

 on the air passages and causes respiratory difficulties, 

 certain individuals with only a small goitre, have a dry 

 cough, coming on in paroxysms and spasmotic in character. 



The respiratory difficulty in some cases consists of a 

 difficulty in dilating the thoracic cage and taking a deep 

 breath (Bryson). 



4. GENITAL DISTURBANCES. 



The genital disturbances are constant in Basedow's 

 disease. 



In man there is frigidity or impotence. In women the 

 menses are irregular or may be absent and then re-appear. 

 The breasts nearly always become atrophic. 



5. URINARY DISTURBANCES. 



Polyuria occurs at intervals very much like the attacks 

 of diarrhea. 



During the periods in which the goitre is growing 

 rapidly albuminuria and even glycosuria can be noticed. 

 This glycosuria seems to be the result of hyperthyroidism. 



6. GENERAL SYMPTOMS. 



Fever is not exceptional in Basedow's disease. It oc- 

 curs at intervals and lasts for a variable length of time. 



The examination of the blood show r s a leukopenia with 

 lymphocytosis (Kocher). These blood changes are very 

 constant and are also found in the abortive cases. 



6 



