82 ENDOCRINE GLANDS 



EVOLUTION. 



Basedow's disease may evolute very quickly. It may 

 develop after a fright. The sudden increase in the volume 

 of the thyroid causes asphyxiating symptoms, associated 

 with cyanosis suffocation, often made worse by an asso- 

 ciated enlargement of the thymus. It may improve and 

 be the starting point of a slow evoluting type of case. 



In the majority of cases the evolution lasts for years, 

 and progresses by sudden periods of activity during 

 which the chief symptoms increase in intensity and are 

 separated by intervals of remission or even regression 

 which last a variable length of time. 



The general health for a long time stays unimpaired. 

 In spite of the fact that these patients have a good appe- 

 tite, some of these patients lose weight for weeks or 

 months at a time. These periodic spells of loss of weight 

 occur without any apparent cause or after diarrhea; be- 

 tween these periods they regain weight. In this manner, 

 the evolution is very slow. 



Cure is very frequent. It may occur spontaneously, 

 but in the majority of cases is rarely complete. The 

 secondary symptoms decrease and may disappear, but 

 exophthalmos, thyroid hypertrophy and tachycardia 

 persist and recurrence is to be watched for. 



In other cases, the condition grows worse after several 

 exacerbation. 



The patient dies from tuberculosis, progressive cachexia 

 or from cardiac complications. 



1. PLEURO-PULMONARY TUBERCULOSIS in one of its 

 various forms is a frequent complication. 



2. CACHEXIA characterizes certain cases. They have 

 anorexia, incoercible vomiting, profuse diarrhea, albumi- 

 nuria and in spite of the absence of any evidence of 



