In Graves's disease the body-resistance to the passage of the electrical current is lowered in a remarkable manner: a point to which Charcot was first to draw attention. This peculiarity as cribed to the diminished resistance of the vasomotor dilatation of the 'skin capillaries, which thus render the skin saturated with fluid, and practically reduce the thickness of the ill-conduct ing epidermis to a minimum. R. Norris Wolfenden (_lied. Abstract, Jan., '88).
Low electrical resistance is frequently found in Graves's disease. In doubtful cases it is a valuable positive sign, but its absence in such cases has no weight. A. Eulenberg (Berliner klin. Woch., Jan. 14, '89).
Diminished electrical resistance found in 15 out of 20 cases of exophthalmic goitre. But this sign is worthless for diagnosis, as the electrical resistance varies with the moisture of the skin. The resistance greatly lessens when the skin perspires. Volkel ("Ueber einseiti gen Exophthalmus bei Morbus Base dowii," '90).
Diagnosis of Graves's disease may be made when delirium cordis and tremor are present, but not without these, all other symptoms being secondary and comparatively unimportant. Lemke (Dent. med. Woch., Dec. 20, '94).
Under PATHOLOGY I will indicate the grounds for thinking that the thyroid secretion may play a certain part in the quasiphysiological phenomena which fall within the bounds of ordinary health, and if this is true much light may be expected from the further analysis of these states.
Etiology.—Graves's disease is found among men and among women, and even among animals; and may occur in child hood,—even infancy,—in adolescence, in adult life, and rarely in old age. It is, however, far more common among women than among men, and almost always shows itself first during early adult life.
Graves's disease is very rare in chil dren, twenty-four (Lases only having been reported. Most of these reported cases occurred in girls, the average age vary ing from 8 to 13. One case was recorded at the age of 2 V, years. In many the exciting cause was unknown; in some the cause seemed to have been a sudden shock. The writer adds two more cases of Graves's disease occurring in children.
Tremor and Graefe's symptom are generally absent in children, but chorea often forms a complication. The prog nosis in children is not unfavorable, some recovering completely, and others only having slight cxophthalmos subse quently. Dreschfeld (Practitioner, Aug.,
'96).
Exophthalmic goitre occurs approxi mately 4.5 times as often in females as in males; the disease is most common during the period of active adult life, occurring earlier in females than in males; the disease is uncommon, if not rare, in the black race. A. A. Eshner (Inter. Med. Mag., Apr., '98).
Forty - two cases of exophthalmic goitre collected in children below the age of fifteen, the youngest being a child four and one-half years old. These figures show that the condition is un common in childhood, especially in the earlier years. Symptomatology does not differ much from that of the ordinary form, and the three cardinal symptoms of tachycardia, goitre, and exophthal mos exist, though the last is sometimes less marked than in adults, and may be unilateral. Tremor is also uncommon in the child, but, on the contrary, chorea is very frequent. There is great irrita bility of character. The disease is apt to come on more rapidly in a child. sometimes appearing suddenly or be coming apparent in the course of a few days, the cardiac phenomena being the first to attract attention. In some cases goitre is present for a considerable time before the appearance of the other symptoms. The writer records some in stances in which tremor was the first symptom to appear, and fatigue and headache usually set in early. The duration of the disease is not so long as in the adult. Barret (Jour. de Med. et de Chin Prat.. July 10. 19021.
No race is wholly exempt, nor the in habitants of any special country, and none are very much more prone to the disease than the others. Every now and then the claim is made that it is espe cially common in one or another place or section of country, but this is not borne out by prolonged investigation and is probably an example of the acci dental coincidences in which the of medicine abounds. On the other hand, there is rather more reason to think that Graves's disease is more common in districts where simple goitre is endemic. If this prove true the fact would har monize with the observation that the special kind of goitrous affection met with in Graves's disease is more likely to occur on a basis of thyroid disease of other sorts than on a basis of health. On the other hand, this relative frequency of Graves's disease in goitrous districts is not so great as would probably be the case if simple goitre acted by mechanical irritation.