. The thyroid gland in health and disease. and burning sensations of the skin. The hair falls out or becomes prematurely grey. It is coarseand dry, the sebaceous glands failing to oil it properly. A thickdirty crust is apt to collect on the scalp and around the rootsof the hair. The hair first disappears from above the forehead—the frontal band alopecia of Walsh (fig. 74). Later it fallsoff from the nape of the neck—the cassowary neck. The eye-brows fall out, especially the outer one-third ; and this eyebrow 182 MYXCEDEMA sign, to which attention was first directed by Hertoghe, isone of great
. The thyroid gland in health and disease. and burning sensations of the skin. The hair falls out or becomes prematurely grey. It is coarseand dry, the sebaceous glands failing to oil it properly. A thickdirty crust is apt to collect on the scalp and around the rootsof the hair. The hair first disappears from above the forehead—the frontal band alopecia of Walsh (fig. 74). Later it fallsoff from the nape of the neck—the cassowary neck. The eye-brows fall out, especially the outer one-third ; and this eyebrow 182 MYXCEDEMA sign, to which attention was first directed by Hertoghe, isone of great vakie especially as an aid to the detection of mildcases of the disease. The eyelashes also may disappear, andmarginal blepharitis may occur. The axillary and pubic hairfalls off in like manner. The mucous membranes share in this process of conjunctivae are thickened and are very apt to suffer frominflammatory states ; lachrymation is frequent. The mucousmeinbrane of the nose is similarly affected ; that of the mouth,. Fig. 73.—Young man before the onsetof myxcedenia. Fig. 74.—The same after the develop-ment of inyxoedema. (From photographs in the possession of the late Sir Victor Horsley, ) palate and uvula is pale in colour and much swollen. The giunsalso are swollen and pyorrhoea alveolaris is very common ; theteeth may be covered with a greenish tartar at their roots. Thebreath is foetid. The mucosa of the larynx and vocal cords is alsoinvolved, making talking difficult, the voice harsh and singingimpossible. The loss of the high notes in the singers voice is anearly sign to which attention has been directed by Granger. Anirritating cough is a common symptom. The tongue is thick andswollen, its whole substance being involved in the infiltrationprocess, and may protrude from the mouth in young people. BONES, CARTILAGES, LIGAMENTS, AND MUSCLES 183 It bears on its surface the indentations of the teeth. The tonsilsare enlarged ; the subjects of th
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