. A practical treatise on medical diagnosis for students and physicians . from vascular dilatation, the swelling atfirst subsiding in the intervals between attacks, but subsequently persist-ing. The right lobe may be larger than the left. The enlargement ispainless, soft, and compressible. It may pulsate with or without thrill,and over it can be heard hsemic murmurs. EXOPHTHALMIC GOITRE. 853 The Eyes. Prominence of the eyes is the most conspicuous featureof well-marked cases. Like enlargement of the thyroid, it varies indegree, and rarely is wholly absent. The protrusion allows the whitesclero
. A practical treatise on medical diagnosis for students and physicians . from vascular dilatation, the swelling atfirst subsiding in the intervals between attacks, but subsequently persist-ing. The right lobe may be larger than the left. The enlargement ispainless, soft, and compressible. It may pulsate with or without thrill,and over it can be heard hsemic murmurs. EXOPHTHALMIC GOITRE. 853 The Eyes. Prominence of the eyes is the most conspicuous featureof well-marked cases. Like enlargement of the thyroid, it varies indegree, and rarely is wholly absent. The protrusion allows the whitesclerotic to show above and below the cornea, giving the eyes an un-natural, startled, staring appearance. The protrusion may be so greatthat the eyelids can not close ; more commonly they close, but when theeyeball is simply directed downward the upper eyelids do not follow butremain spasmodically elevated or lag behind the movement of the eye-ball. (Yon Graefes sign.) The eyeball may become inflamed and evenslough from undue exposure. In rare instances one eyeball alone is. Exophthalmic goitre. (Original.) affected, and in these cases the lobe of the thyroid of the opposite sideis enlarged. Stelwags sign (widening of the palpebral fissures) is thethird ocular sign of significance in exophthalmic goitre. Finally, Mobiuscalls attention to the frequency of insufficiency of the internal rectimuscles. In addition to these characteristic symptoms loss of flesh and strength,moderate pyrexia of irregular type, impaired appetite, diarrhoea, anddespondency are observed. The diarrhoea is of the nervous type—increased peristalsis without local catarrh. The menstruation is apt to bedisturbed. Tinnitus aurium, headache, and vertigo are not uncommon,and sometimes there is profuse sweating. A restless, nervous excitement(Charcot) is very common. Muscular tremor (Marie), occurring on volun-tary movement, is frequently observed, and with diarrhoea is almost ascommon as the three primary symptoms.
Size: 1317px × 1898px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, bookidpracticaltre, bookyear1904
