THE THYROID GLAND. 939 
by the anal) r ses of Halliburton ; ! but not to the extent believed when 
the term myxcedeina 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 
myxcedema 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 myxcedema ; he accordingly termed 
the collection of symptoms " operative myxcedema." i 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 " myxcedema." 
They are liable, amongst other symptoms, to a form of conjunctivitis 
1 Trans. Clin. Soc. London, 1888, vol. xxi. Suppl. ; Journ. Path, and Bacterid., Edin. 
and London, 1892. 
2 Med.-Chvr. Trans., London, 1878. See also Hadden, Brain, London, 1883, p. 193, 
and S. Mackenzie, Trans. Clin. Soc. London, 1888 (Report of Committee on Myxedema), for 
an account of the symptoms of myxcedema in the human subject. For a very full bibliography 
of observations on the thyroid and its connection with myxcedema, see Ord, in Allbutt's 
"System of Medicine," 1897, vol. iv. 
3 Rev. med. de la Suisse Bom., Geneve, 18S2, p. 539; 1883, Nos. 4 to 6 ; 1887, pp. 
275, 328. 
4 Termed also "cachexia strumipriva" and " cachexia thyreopriva. " 
s Arch. f. klin. Chir., Berlin, 1883, Bd. xxix. S. 254. 
6 Rev. med. de la Suisse Bom., Geneve, Feb. and Aug. 1884, Bd. xviii. S. 25. 
7 Schiff's clogs 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. 
"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. Boy. Soc. London, 1884 and 1886, and Brit. Med. Journ., 
London, 1885, vol. i. p. 3 ; 1892, vol. i. p. 267 ; also Festschr. Rudolf Virchow, Berlin, 
1891; Fuhr, Arch. f. expcr. Bath. u. Pharmakol., Leipzig, 1886, Bd. xxi.; 18S9, Bd. xxv. ; 
Rogowitsch, Ceutralbl. f. d, med. Wisscnsch., 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 ; Hotfa, Sitzungsb. d. phys.-med. Gesellsch. zu Wurzburg, 1887, 
S. 104; Ewald, Berl. klin. Wchnschr., 1887, 1889. and 1895 ; v. Eiselsberg, " TJeber 
Tetanie im Anschluss an Kropfexstirpationen," Wien. klin. 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. 
