THE THYROID APPARATUS 



95 



CACHEXIA THYROPRIVA. 



Retarded digestive and excre- 

 tory processes, small appe- 

 tite, slight need for food. 



Slow metabolism. 



Thick, opaque skin, dry or 

 scaly. 



Short, thick fingers, frequently 

 broadened at the tips. 



Sleepiness and desire for sleep. 



Retarded sensation, perception 

 and action. 



Mental vacancy and indiffer- 

 ence, lack of emotion. 



Awkwardness and slowness of 



movement. 

 Stiffness of the extremities. 



Retarded skeletal growth, 

 short, thick, frequently 

 deformed bones. 



Constant chilliness. 



Difficult and slow respiration. 



Increase in weight. 

 Senile appearance, 

 young people. 



even of 



GRAVES'S DISEASE. 



Abundant excretion, generally 

 abnormal appetite, in- 

 creased need for food. 



Increased metabolism. 



Skin thin, transparent, finely 

 injected, moist. 



Long, slender fingers, with 

 pointed tips. 



Insomnia and restlessness dur- 

 ing sleep. 



Intensified sensation, perception 

 and action. 



Mental whirl, excitement to the 

 point of hallucination, 

 mania, melancholy. 



Perpetual restlessness and 

 haste. 



Tremor of the extremities, in- 

 creased mobility of the 

 joints. 



Slightly built skeleton, occa- 

 sionally soft or thin bones. 



Unbearable sensation of heat. 



Superficial respiration, slight 

 expansion of the thorax in 

 inspiration. 



Loss of weight. 



Youthful, luxuriant develop- 

 ment, at least in the earlier 

 stages. 



The antagonism between the principal symptoms of the two 

 conditions is very marked, though occasionally in severe cases of 

 Graves's disease symptoms appear which bear a close resemblance 

 to those of cachexia strumipriva. 



Other momenta, such as the deleterious effects of the exhibi- 

 tion of thyroid extract in Graves's disease and the artificial pro- 

 duction of the symptoms of Graves's disease by hyperthyroidism, 

 are to be regarded, not as direct proofs of the thyrogenic origin 

 of this condition, but as powerful arguments in its favour. 



We will now pass to a consideration of the symptoms and 

 organic changes characteristic of Graves's disease. 



The thyroid enlargement the goitre is one of the constant 

 symptoms of the condition. Cases where the thyroid changes are 

 absent are, in the opinion of all observers, extremely rare. The 



