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September 8, 1934


JAMA. 1934;103(10):772. doi:10.1001/jama.1934.02750360048026

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To the Editor:—  The editorial on "The Mechanism of Exophthalmos" in The Journal, June 30, quotes what is termed "this curious statement" from my recent textbook "Diseases of the Nervous System": "Apart from gross neoplastic and inflammatory lesions of the orbit, the mechanism of expohthalmos is still little understood." Your comment is: "Nevertheless the mechanism of exophthalmos is well understood, though the knowledge would seem to be poorly disseminated." If the writer of your leader had done me the honor of quoting the article on exophthalmic goiter in my textbook, he would have found the explanation of exophthalmos which he proposes fully discussed and the conclusion drawn that "there is probably overaction of part of the ocular sympathetic fibers, causing retraction of the upper lids and some degree of exophthalmos." I am familiar with the various papers quoted in the leader and I agree that the muscles described by Landström

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