THE THYROID GLAND. 939 



by the analyses of Halliburton ; l but not to the extent believed when 

 the term myxoedema was applied to this condition. Nor is the condi- 

 tion really one of oedema, but rather of hyperplasia of the connective 

 tissue, which becomes altered, assuming a more embryonic character, 

 hence its richness in mucin (see note 1, p. 942). The connection of 

 myxoedema with affections of the thyroid was first recognised by Ord 2 

 in 1878 an observation which has since been abundantly confirmed. 

 In 1882, J. L. Eeverdin 3 described the symptoms which follow com- 

 plete removal of the thyroid body for goitre in man, and recognised 

 these symptoms as identical with those of the disease which had been 

 described under the name of myxoedema; he accordingly termed 

 the collection of symptoms " operative myxoedema." 4 The results of 

 Eeverdin were speedily followed by those of Kocher, who described, in 

 a large number of cases, similar symptoms as following entire removal 

 of the thyroid in man. 5 Kocher pointed out that the effects are most 

 marked in young subjects, and that they may not occur at all or 

 be little manifest as age advances. These observations of Eeverdin 

 and Kocher led to a renewal of his former experiments by Schiff, 6 who 

 in 1884 published the results of sixty thyroidectomies upon dogs, in all 

 of which the result was speedily fatal, 7 the operation being quickly 

 followed by the supervention of symptoms tremors, spasms, and 

 convulsions which seemed to point to a serious derangement in the 

 nutrition of the central nervous system. 8 Schiff also discovered the 

 fact that the symptoms are prevented by a previous graft of a portion 

 of the gland beneath the skin or into the peritoneal cavity. 



Dogs do not show the swollen condition of the connective tissues 

 which is a characteristic feature after thyroidectomy in man; this 

 appears to be due to the fact that in them a fatal result usually occurs 

 too rapidly to allow of the development of the so-called " myxoedema." 

 They are liable, amongst other symptoms, to a form of conjunctivitis 



1 Trans. Clin. Soc. London, 1888, vol. xxi. Suppl. ; Journ. Path, and Bacterial., Edin. 

 and London, 1892. 



2 Med.-CMr. Trans., London, 1878. See also Hadden, Brain, London, 1883, p. 193, 

 and S. Mackenzie, Trans. Clin. Soc. London, 1888 (Report of Committee on Myxoedenia), for 

 an account of the symptoms of myxoedema in the human subject. For a very full bibliography 

 of observations on the thyroid and its connection with inyxcedema, see Ord, in Allbutt's 

 "System of Medicine," 1897, vol. iv. 



3 Rev. med. de la Suisse Rom., Geneve, 1882, p. 539; 1883, Nos. 4 to 6 ; 1887, pp. 

 275, 328. 



4 Termed also "cachexia strumipriva" and " cachexia thyreopriva." 



5 Arch. f. Uin. Chir., Berlin, 1883, Bd. xxix. S. 254. 



6 Rev. med. de la Suisse Rom., Geneve, Feb. and Aug. 1884, Bd. xviii. S. 25. 



7 Schiff 's dogs lived at longest fourteen days, when both lobes were simultaneously 

 removed ; if the removal was effected in two sittings, at a certain interval apart, the advent 

 of the characteristic symptoms was delayed or altogether averted. 



8 These experiments of Schiff have been confirmed by many subsequent observers, but the 

 literature of the subject is enormous, and only a few papers can here be mentioned Wagner, 



Wien. med. BL, 1884, S. 25 and 30 ; Sanguirico and Canalis, Arch. per le sc. med., Torino, 

 1884, tome viii. ; Horsley, Proc. Roy. Soc. London, 1884 and 1886, and Brit. Med. Journ., 

 London, 1885, vol. i. p. 3 ; 1892, vol. i. p. 267 ; also Festwhr. Rudolf Virchow, Berlin, 

 1891; Fuhr, Arch. f. exper. Path. u. Pharmakol., Leipzig, 1886, Bd. xxi.; 1889, Bd. xxv. ; 

 Rogowitsch, Centralbl. f. d. med. Wissensch., Berlin, 1886, S. 530, and Arch, de physiol. 

 norm, etpath., Paris, 1888, p. 419 ; Albertoni and Tizzoni, Centralbl. f. d. med. Wissensch., 

 Berlin, 1885, S. 419 ; Hoffa, Sitzungsb. d. phys.-med. Gesellsch. zu Wiirzburg, 1887, 

 S. 104; Ewald, Berl. Uin. Wchnschr., 1887, 1889, and 1895 ; v. Eiselsberg, " Ueber 

 Tetanic im Anschluss an Kropfexstirpationen," Wien. Tclin. Wchnschr., 1890 ; Gley, 

 Arch, de physiol. norm, etpath., Paris, 1892, and subsequent volumes ; Cristiani, ibid., 1893 ; 

 Langhans, Virchow's Archiv, 1892, Bd. cxxviii. S. 400 ; Domenicis, Wien. med. Wchnschr., 

 1895, S. 1620; G. Rouxeau, Arch, de physiol. norm, etpath., Paris, 1897, tome ix. p. 136. 



