Page:Popular Science Monthly Volume 51.djvu/497

Rh as to their own appearance and to the attention which it attracts, and consequently shun society; and for this reason partly, and partly because of their muscular weakness and subnormal temperature, they "like nothing so well as staying quietly in the house. The onset of the disease is gradual and its progress is slow, ordinarily extending over a period of several years. It most frequently occurs in women of middle age. Altogether myxœdema, although not a direct menace to life, makes the victim of it very uncomfortable and unhappy.

The appearance of a person suffering from advanced myxœdema is so characteristic that when one has seen a case there is usually no difficulty in recognizing another. In the earlier stages, however, when the disease is beginning, its diagnosis may be difficult or temporarily impossible.

Myxœdema is not a common disease in this country, and until five years ago was regarded as incurable. But as physicians become more familiar with the condition, which after all has only been recognized for about twenty years, and more especially as the possibility of curing it becomes more widely known, it is altogether probable that we shall find the disease less rare than we have been led to suppose.

The series of experiments which led to the employment in this disease of the thyroid glands of animals resulted in discoveries so complete and definite that it became possible to predict that the thyroid treatment of myxœdema would be a success. Before Sir William Gull described the affection and claimed for it a place of its own among the list of distinct diseases, it had been regarded as a variety of Bright's disease. But to the trained eye the resemblance of myxœdema to Bright's disease was too superficial to be satisfying; and, furthermore, when these patients died their kidneys, which would have shown disease changes if they had been responsible for the symptoms observed in life, were found to be normal. So the first step forward in our knowledge of the disease was the establishment of the fact that the seat of the trouble was not in the kidneys; it was not discovered until later that it was in the thyroid gland. This discovery came about from several sources.

It was observed by physiologists that animals from which the thyroid gland had been removed developed a condition of œdema and stupidity; and several surgeons reported that patients from whom the thyroid gland had been removed by operation for various causes developed symptoms almost identical with those of the cases which had been regarded as examples of Bright's disease, but in whom the kidneys were found nearly normal.

This experimental evidence was amplified by the work of