File:Nervous and mental diseases (1919) (14595013240).jpg

Identifier: nervousmentaldis00chu (find matches)
Title: Nervous and mental diseases
Year: 1919 (1910s)
Authors: Church, Archibald, b. 1861 Peterson, Frederick, 1859-1938, joint author
Subjects: Nervous system Mental illness
Publisher: Philadelphia, London, W.B. Saunders company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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nnection with alimentary processes in the lower orders. Morbid Anatomy.—^The primal lesion of myxedema is located inthe thyroid. In myxedematous idiocy the gland is either wanting, rudi-mentary, or atrophic. In acquired myxedema it is atrophic, yellowishwhite, and fibrous. At first there appears to be an embryonal vesicular 526 NEUROSES. infiltration, with epithelial proliferation. Later, fibrous changes pre-dominate, and finally complete sclerosis is presented. This practicallyconstitutes a parenchymatous and interstitial thyroiditis. Murray, how-ever, believes that atrophy of glandular tissue is the first step, dueprobably to the action of some toxic agent, and that the increase offibrous tissue is a replacement-fibrosis. The cystic degeneration ofcretinoid goiter reaches the same results by its destructive action uponthe glandular parenchyma. The subeutaneous cellular tissues are infiltrated with a gelatinous,mucinoid substance and the fatty panniculus is much increased. Through-
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Fig. 2236.—Skiagram of hands of Fig. 223* out the organism there is a tendency to fibrous proliferation, whichespecially aifects glandular organs, as those of the skin and the kidneys.Mucin has also been found in the blood and in all the tissues of thebody. The pituitary gland and the thymus are frequently enlarged,apparently for the purpose of compensation. The nervous system pre-sents no changes that are uniform or significant. Central hyperemiaand tumefaction of the nerve-cells have been noted by Rogowitch. Treatment.—The treatment of myxedema furnishes one of themost brilliant chapters in medicine. It was observed that in animalsand man myxedema did not follow partial ablation of the thyroid, andSchiff found that a portion of the gland subcutaneously or intraperitoneallyimplanted prevented the myxedematous state in animals subsequently thy-roidectomized. Horsley suggested the same procedure in man, and it GLANDULAR NEUROSES. 527 was carried into effect by Kocher, Laimelongue,

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