Clinical notes on Graves' disease / by Professor Grainger Stewart and G.A. Gibson.

  • Stewart, Thomas Grainger, 1837-1900.
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Clinical notes on Graves' disease / by Professor Grainger Stewart and G.A. Gibson. 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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    This case was very interesting on account of the larger size of the right lobe of the thyroid gland, the well-marked change in the haii', and the presence of diabetes niellitus. Case 3.—Peter C, set. 31, accountant, unmarried; was admitted to Ward 22 on 19th July 1892, complaining of swelling of the legs. His father is alive and in good health. His mother died at the age of 75, of cardiac failure. He has had a brother and a sister, both older than himself. His brother is in excellent health, but his sister died of enteric fever at. the age of 27. The patient states that his health has always been good, except that he had last autumn a rash on the legs, which, from the scars left behmd, has clearly been rupia. About three years ago he fell from a height of about 30 ft. into a harbour. He suffered for nine months afterwards from chronic diarrhoea, and soon afterwards noticed that the eyes were more prominent than they used to be, and that he had a certain amount of palpitation. Breathlessness and swelling of the legs showed themselves shortly afterwards. The alimentary system shows no abnormal symptoms. The thyroid gland is enlarged almost uniformly on both sides. The pulse is 88 per minute, vessel empty, tension high, blood-waves small. Apex beat in fifth intercostal space. Right border of heart 2^ in., left border 4 in., from mid-sternum. There is a con- tinuous venous hum over the jugular veuis, and a systolic murmur over the thyroid gland. There is a soft systolic murmur at the apex, propagated for some distance towards the sternum, and for a longer distance towards the axilla. In the tricuspid area there is a soft blowing murmur continued up the sternum as far as the pulmonary area. There is no change in the second somid. There is a trace of albmnen in the urine, but no tube-casts can be found. Marks of old rupia are seen on the legs. The skin shows no increased perspiration, but the hair of the scalp, axilla, and pubes is rather more scanty than formerly.