Hypothyroidism 



NELSON W. JANNEY 



LOS ANGELES 



HISTORICAL 



DEFINITION AND NOMENCLATURE 

 GEOGRAPHICAL DISTRIBUTION 

 ETIOLOGY 

 PATHOLOGY 

 METABOLISM 

 SYMPTOMATOLOGY 

 DIAGNOSIS 

 PROGNOSIS 

 TREATMENT 



Sporadic Hypothyroidism 

 Historical 



Although endemic goiter and cretinism have been known certainly 

 since the times of the Komans, the recognition of sporadically occurring 

 hypothyroidism is comparatively recent. No distinction in early accounts 

 can be drawn between endemic and sporadically occurring cretins which 

 were confused with various diseases exhibiting nanism and imbecility. 

 Curling in 1850 described cases of sporadic cretinism. Myxedema was 

 first described as a clinical entity without recognition of its true etiology 

 in the decennium 1870 to 1880 in England and France. William Gull, 

 in a paper entitled "On a Cretinoid State Supervening in Adult Life in 

 Women," reported to the Clinical Society of London in 1873 five cases. 

 The term "Myxedema" was supplied by W. H. Ord in 1878. In France, 

 the disease did not escape Charcot's (a) shrewd discernment, who described 

 it in 1879 under the term "Cachexie Pachydermique." Myxedema was 

 thought to be confined to females until Savage reported a male case in 

 4880. 



Next ensued the period of etiologic connection of the disease with the 

 thyroid. Madden, in 1880, noted the regular occurrence of thyroid atro- 

 phy in myxedema though the significance of this finding escaped him. 

 T. Kocher (a) called attention as early as 1874 to the effects of total stru- 



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