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This is a condition having many manifestations and due to a deficiency of the internal secretion of the thyroid gland. It may occur as the result of illness in childhood, in which case development, mental and physical, is much impaired, or, as is more usual, it may become manifest in later middle life. It is more often seen in women than in men, and mild degrees are very common at the time of the menopause. The name was first given to the condition owing to an appearance of oedema or swelling of the body from infiltration of the tissues with a gelatinous mucous-like material.
Slight degrees of myxoedema are very common, and arc often missed owing to the slow progress of the changes to which they give rise, but when wcll developed the appearance is unmistakable. Coarsening of features. growth in bulk, increasing slowness of speech, thought and movement. and a marked intolerance of cold combine to form a group of symptoms that arc produced. by no other cause than thyroid deficicncy. The face becomes bloated, with puffy swelling of the eyelids. simulating the ocdcma of Bright's disease; there is roughening of the skin and a change in complexion to a muddy, sallow tint except for a pink flush over the bones of the upper jaw. There is loss of hair from the scalp and eyebrows, especially from their outer parts, and a coarsening and lack of growth in the hair that remains.
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There is a marked tendency for deposits of fat to form in certain situations, especially above the collar bones, in the abdominal wall and in the breasts. The hands become spade-like owing to thickening of the fleshy parts of the fingers, and the whole conformation of the body tends towards a massive shapelessness. The action of the heart becomes feeble and slow, and there is a persistcnt fall of blood pressure and general sludgishness of the vital functions of stomach, bowel and kidney. Causes of such a marked failure of thyroid activity include the e,ffects of severe infective illnesses and abnormal growths and degenerations of the thyroid gland, but in many cases no definite cause can be assigned, and the condition must be regarded as a premature exhaustion of the gland.
Myxoedema: HANDS
A broad, short, spade like hand is characteristic of myxoedema and occurs with other changes, coarsening of the skin, etc., and with mental dullness.
Left, the devitalizing effect of insufficient thyroid gland secretion, with the coarsened myxoedematous features, is well seen. Right, the same adult thyroid treatment.
Treatment by Gland Extract
The improvement that follows the administration of thyroid gland preparations to such a case is startling. Under the iufluence of doses of dried thyroid gland of animals all the signs and symptoms may disappear and the unfortunate victim he restored to the appearance and reality of health.
So powerful are the effects of this remedy in these cases that there is some danger of thyroid gland substances being given to excess. Their action must be closely watched, and when once definite improvement has set in it is often veise to reduce the dose and the frequenct of its administration. Harmful effccts that must he looked for are rapid heart action, with or without symptoms of distress, diarrhoea, nervousness, flushing, breathlessness and loss of sleep. But cessation of the treatment is followed in almost every case by a return of the symptoms.
At first the dosage should be small, namely, two grains of the dried extract of the thyroid gland of sheep. If no symptoms of intolerance appear with such a dose it may profitably be increased gradually till the patient is taking ten grains a day, but such a heavy dosage should never be administered unless the patient is under skilled supervision. It is advisable to determine by experiment the smallest dose that will keep the myxoedematous symptoms in abeyance and to restrict the amount to this.