A new point in the diagnosis of Graves' disease / by R. Norris Wolfenden.

  • Wolfenden, Richard Norris.
Date:
[1887]
Catalogue details

Licence: Public Domain Mark

Credit: A new point in the diagnosis of Graves' disease / by R. Norris Wolfenden. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    It is evident how low the body resistance is in Graves' disease, and the fact that it is so even in the undeveloped or early forms of this disorder shows how, valuable the point is as an aid to diagnosis, and the tnith of Charcot's remark that cases of the undeveloped form would sometimes be very difficult to diagnose, were it not for the palpitation, tremor, and diminution of elec- trical resistance revealing their true nature. In one such case he found the latter register only 1170 ohms and in another only 900 ohms. But in order to make the point of diagnostic value, it must be shown how the body resistance is altered in various other forms of disease. First, it assists to a certain diagnosis of the goitre of Graves' disease from forms of simple goitre. Where one has to rely on a number of minor signs for this jDurpose, the importance I of such an aid can scarcely be overestimated. Cases of goitre find their way to the surgeon frequently, in which but little palpitation is' complained of, and in which there is no exophthalmos, and the true nature of which is overlooked. Since the treatment is so widely different for the two forms of thyroid swelling, and that designed for the one class of case would often aggravate the other, such an objective sign, so easily ob- tained, would lead to a true appreciation of the case, or at any rate raise suspicions which would lead the practitioner to seek for a number of the minor signs which are constantly found to occur in Graves' disease but not in simple goitre. In ordinary goitre the body resistance is not diminished. In one case I found it to be 5000 ohms, in a second 5000 ohms, in a third 6000 ohms. En other cases I have found it to be never under 5000 ohms. In a case of malignant disease of the thyroid it registered 8000 ohms. As for other nervous conditions, I examined seven cases of hemiplegia, and found it vary between 1,300 and 4000 ohms. In seven cases of epilepsy it varied between 1000 and 4000 ohms, in three cases of cerebral softening it averaged 3000 ohms, in two cases of paraplegia it averaged 3000 ohms, in one case of general paralysis it stood at 6,500 ohms, in one case of infantile paralysis it was 2,600 ohms, and in a case of hystero-epilepsy 1,600 ohms. It is thus seen that in epilepsy, and to a lesser degree in hemi-