1911 Encyclopædia Britannica/Myxoedema

MYXOEDEMA (or athyrea), the medical term for a constitutional disease (see Metabolic Diseases) due to the degeneration of the thyroid gland, and occurring in adults; it may be contrasted with cretinism, which is a condition appearing in early childhood. There are two forms, myxoedema proper and operative myxoedema (cachexia strumipriva). (1) Myxoedema has been termed “Gull’s Disease” from Sir William Gull’s observations in 1873. Women are more often the Victims than men, in a ratio of 6 to 1. It frequently affects members of the same family and may be transmitted through the mother, and it has been observed sometimes to follow exophthalmic goitre. The symptoms are a marked increase in bulk and weight of the body, puffy appearance of skin which does not pit on pressure, the line of the features becoming obliterated and getting coarse and broad, the lips thick and nostrils enlarged, with loss of hair, subnormal temperature and marked mental changes. There is striking slowness of thought and action, the memory becomes defective, and the patient becomes irritable and suspicious. In some instances the condition progresses to that of dementia. The thyroid gland itself is diminished in size, and may become completely atrophied and converted into a fibrous mass. The untreated disease is progressive, but the course is slow and the symptoms may extend over 12 to 15 years, death from asthenia or tuberculosis being the most frequent ending. (2) Symptoms similar to the above may follow complete removal of the thyroid gland. Kocher of Bern found that, in the total removal of the gland by operation, out of 408 cases operative myxoedema occurred in 69, but it is thought that if a small portion of the gland is left, or if accessory glands are present, these symptoms will not develop. The treatment of myxoedema is similar to that of cretinism.