90 ENDOCRINE GLANDS 



They are found in cases of goitre in which the respiratory 

 passages are compressed by the hypertrophied thyroid. 



In others, the cardiac manifestations are independent 

 of all pulmonary affections. The goitre varies in size; 

 in some cases it is even small, retro sternal and can be even 

 overlooked, while the patient complains of violent palpi- 

 tations, coming on spontaneously or after the slightest 

 effort. The heart is enlarged and beats between 100 and 

 140 and becomes accelerated and arythmic at the slightest 

 provocation. More dangerous symptoms, in particular 

 pains simulating angina pectoris, sometimes occur. 



Asystole is the usual result of these cardiopathic goitres. 



Sometimes it is possible in these cases to note simultan- 

 eously a slight exophthalmos and a peculiar brilliancy of 

 the eyes. According to Kraus, the removal of the goiter 

 causes the disappearance of these symptoms. For these 

 reasons, these cases are considered as abortive cases of 

 Basedow's disease. 



ii. BASEDOW'S SYNDROME FOLLOWING THE INGESTION 



OF THYROID OR IODIDES. 



\ 



In patients taking an excessive quantity of thyroid or 

 following a course of thyroid medication for too long a 

 period of time (for instance in the treatment of myxedema, 

 or for stout women to reduce without proper medical 

 supervision) the syndrome of Basedow's disease may 

 appear more or less distinctly with tachycardia, exoph- 

 thalmia, tremor, restlessness, nervosity, insomnia, etc. 



This syndrome is usually temporary and will disappear 

 after the removal of the cause. Similar symptoms may be 

 seen in patients with simple goitres which have been 

 given iodides. 



3. SYNDROME OF BASEDOW'S DISEASE OF OVARIAN 

 ORIGIN. In certain young girls at the time of puberty, 



