CASES OF EXOPHTHALMIC GOITRE, 



(Reprinted from St. Bartholomew's Hospital Reports, vol. x, 1875.) 



Xhis disease is characterised by three prominent symptoms— 

 viz., palpitation of the heart, enlargement of the thyroid gland, 

 and protrusion of the eyeballs. It was first observed by Parry, 

 and described by him in a paper on " Enlargement of the 

 Thyroid Gland in connection with Enlargement and Palpitation 

 of the Heart," published in 1825. Parry's work, however, seems 

 to have been little known, and the disease was again noticed by 

 Graves of Dublin, and described by him under the title of 

 " Newly observed Affection of the Thyroid Gland in Females," 

 in his System of Clinical Medicine, published in 1843. The 

 attention of the profession having been attracted to the disease 

 by Dr. Graves, it is generally called Graves' disease in this 

 country, and " maladie de Graves " by Trousseau in France. 

 Both Parry and Graves observed the protrusion of the eyeballs, 

 as well as the other symptoms, but they seem to have regarded 

 it as quite subsidiary to the other two symptoms, and perhaps 

 looked upon it as an accidental complication. The equal im- 

 portance of the exophthalmic with the other symptoms was 

 first insisted upon by Basedow, a practitioner in the German 

 town of Merseburg. He is therefore considered by the Germans 

 to have been the first to give a complete picture of the disease, 

 and they call it after him *' die Basedow'sche Krankheit," or 

 Basedow's disease. 



In most of the cases described by Graves the paroxysmal 

 nature of the palpitation, and of the increased enlargement of 

 the thyroid, forms a prominent symptom, and appears to have 

 specially attracted his attention. In these cases the protrusion 

 of the eyeballs does not seem to have been at all noticeable ; 

 while in most cases where this symptom is prominent, the 

 thyroid gland, although subject to occasional variations in size, 

 generally remains more or less obviously enlarged. The follow- 



