Nervous and mental diseases . ional cases and proposed the word myxedema (mucousswelling). Charcot, about this time, struck by the cutaneous thicken-1 McCord, Jour. Amer. Med. Assoc, July, 1914, p. 232. GLANDULAR NEUROSES, 519 ing and the cachectic state, used the term pachydermatous 1880 Bourneville and dOlier described a case of myxedematousidiocy and subsequently many more. In 1882 Reverdin, and shortlyafterward Kocher, reported myxedema following complete extirpationof the thyroid, for which they severally proposed the terms of operativemyxedema and cachexia sfrumipriva. The an
Nervous and mental diseases . ional cases and proposed the word myxedema (mucousswelling). Charcot, about this time, struck by the cutaneous thicken-1 McCord, Jour. Amer. Med. Assoc, July, 1914, p. 232. GLANDULAR NEUROSES, 519 ing and the cachectic state, used the term pachydermatous 1880 Bourneville and dOlier described a case of myxedematousidiocy and subsequently many more. In 1882 Reverdin, and shortlyafterward Kocher, reported myxedema following complete extirpationof the thyroid, for which they severally proposed the terms of operativemyxedema and cachexia sfrumipriva. The analogies between acquiredmyxedema, myxedematous idiocy, and cretinism have been noted bymany, and Brissaud, in his lectures of 1893—^94, brings certain cases ofinfantilism, or physical retardation, into the same category. We willcommence by a description of acquired myxedema in adults. Dueallowance being made for the age and growth of the individual, and thesuddenness and completeness with which the thvroid is affected, will. Fig. 219—A case of myxedema before and after two months trentnipnt by thyroids(Dr. John Woodman). practically enable this description to be applied to all the above-mentioned varieties. Acquired myxedema of adults is of insidious onset, as a rule,and more common in women than in men. It usually appears betweenthe ages of thirty and fifty. Occasionally it has abruptly followed anattack of acute rheumatism, some infectious fever, or a severe hemor-rhage. It is marked by : (1) Tumefaction of the dermal and mucousstructures ; (2) by intellectual and physical enfeeblement, and (3) byatrophy of the thyroid body. The dermal changes are the most striking. The skin is infiltratedwith a mucoid substance and the fatty panniculus is frequently greatlythickened. The swellino; offers an elastic resistance to the touch and 520 NEUROSES. does not pit on pressure. The color is usually pale, yellowish, and waxyor cheesy. The face is enlarged, rounded, and apathetic. The
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