Since 1921, we1 have tried to standardize a therapeutic regimen for patients afflicted with disturbances of the thyroid gland or of the involuntary nervous system. Many unsolved physiologic and clinical problems have rendered our efforts only partially successful. However, necessity compels the therapeutist to evolve a working program and this we shall attempt in what is to follow.
Patients are classified in three groups: (1) those with morphologic changes in the thyroid gland (simple goiter2) but without sympathomimetic symptoms (autonomic imbalance; vide infra) or elevation of the basal metabolic rate; (2) those with sympathomimetic symptoms (autonomic imbalance3) but without elevation of the basal metabolic rate and with or without goiter; (3) those with autonomic imbalance, goiter and definite and sustained elevation of the basal metabolic rate (exophthalmic goiter, the Graves syndrome and Basedow's disease4).
MANAGEMENT OF THE PATIENT
Simple Goiter (Group 1).
—Therapy in this condition
HYMAN HT, KESSEL L. STUDIES OF EXOPHTHALMIC GOITER AND THE INVOLUNTARY NERVOUS SYSTEM: XVII. THE TREATMENT OF PATIENTS WITH DISTURBANCES OF THE THYROID GLAND AND THE INVOLUNTARY NERVOUS SYSTEM. JAMA. 1931;96(24):2014–2019. doi:10.1001/jama.1931.02720500008003
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