Page:Popular Science Monthly Volume 85.djvu/541

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DUCTLESS GLANDS
537

titled to the credit of the original and classical account of the disease, although he did not, as the French say, afficher, that is advertise, his discovery by attempting to label it.

In 1833, Flajani published his account of the disease, in which he recognized two of the cardinal symptoms, the goiter and the cardiac palpitation. In discussing palpitation of the heart at the Meath Hospital in 1835, Eobert Graves, the Dublin clinician, published his classical description of exophthalmic goiter, in which the exophthalmic feature was noted. He records that, in one patient, the beating of the heart could be heard at least four feet from her chest. After the time of Graves and Basedow, many similar observations were collected by clinicians, but it was not until the year 1886 that the condition was attributed to an excessive outpouring of the thyroidal secretion by the German neurologist. Möbius,[1] who at the same time, described a number of related symptom-groups which he regarded as due to qualitative or quantitative changes in the secretion itself ("dysthyroidism"). In connection with the cretins observed by Paracelsus around Salzburg, it is of record that Curling, an English pathologist, first observed that absence of the thyroid body is accompanied by "symmetrical swellings of fat tissue at the sides of the neck, connected with defective cerebral development" (1850). The classical account of this condition is due to Sir William Gull (1873) and it was called myxœdema by William M. Ord, of London, in 1877.

It is a curious fact that the same volume of the journal in which Basedow published his account of exophthalmic goiter contains an observation by Benhard Mohr,[2] a privat docent at Würtzburg, of a remarkable and fatal obesity in an elderly gardener's wife, attended by incipient imbecility (läppisches und kindisches Benehmen), loss of memory, general somnolence and scotoma, which, coming to autopsy, revealed a tumor-like degeneration of the pituitary body produced by inmixture and copious effusion of a serous fluid, the discharge of which had induced pressure phenomena in reference to the adjacent parts of the brain. This was the first recorded case of what is now known as pituitary obesity (1840), the "dystrophia adiposo-genitalis" of Fröhlich and Bartels.

In spite of the amount of original clinical delineation already on record in the first half of the nineteenth century, these lesions of the ductless glands attracted little attention. More interest was excited by the appearance, in 1855, of what we must now regard as the principal milestone in the history of the subject, the monograph "On the Constitutional and Local Effects of Disease of the Supra-renal Capsules," a quarto of 43 pages by Thomas Addison, senior physicion to Guy's

  1. Möbius, Schmidt's Jahrb., Leipzig, 1886, CCX., 237.
  2. Mohr, Wochenschr. f. d. ges. Heilk., Berlin, 1840, VI., 565-571.