86 ENDOCRINE GLANDS 



of symptoms; vaso motor, dyspeptic, etc., which add to 

 their mental state. Their impressionability often leads 

 us to suspect neuropathy or hysteria. 



The cardio vascular disturbances must be looked for 

 carefully, the instability, the hyperexcitability of the 

 pulse, which increases at the slightest effort should lead 

 us to suspect a thyroid lesion. The therapeutic test may 

 be of great help : antithyroid medication may improve the 

 case while thyroid medication, even in small doses exag- 

 gerates the symptoms of this morbid condition, 



ETIOLOGY. 



Basedow's disease is often the late sequel of an infec- 

 tious disease: an acute thyroiditis caused by typhoid 

 fever, scarlet fever, mumps, particularly acute articular 

 rheumatism. It can also be the result of a chronic tuber- 

 culous or syphilitic thyroiditis. 



In certain cases it seems to be the result, as in some 

 cases of diabetes, of a cranial trauma. 



It may begin very rapidly, following violent emotions, 

 fright, moral shock, repeated and deep sorrows. 



Some cases of exophthalmic goitre appear without any 

 apparent cause. 



PATHOLOGICAL ANATOMY. 



There are no specific anatomical lesions of Basedow's 

 disease. 



The thyroid is increased in volume as a whole, the right 

 lobe being usually larger than the other. The thyroid 

 veins are dilated and filled with blood. The gland is of 

 soft consistency, and of a dark brown color. When incised, 

 it often contains cysts filled with colloidal substance. The 

 histological lesion, according to the investigations of 

 Callum, Roussy and Clunet, resemble the compensatory 



