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October 12, 1907


JAMA. 1907;XLIX(15):1235-1238. doi:10.1001/jama.1907.25320150001001

The part assigned to me in this symposium is the diagnosis of this remarkable disease. What I shall have to say is based (1) on an analysis of the cases which have occurred in my wards at the Johns Hopkins Hospital during the past two years,1 and (2) on a study of the bibliography of the subject.2

It will be convenient to discuss (I) the character and significance of the individual signs and symptoms; (II) the diagnosis of the clinical syndrome, especially in its less obvious forms; (III) certain points in differential diagnosis, and (IV) the diagnosis of the indications and contraindications for surgical interference.

On account of the necessity of brevity I am forced to limit the discussion to the features which I regard as most essential.

I. THE CHARACTER AND SIGNIFICANCE OF THE INDIVIDUAL SIGNS AND SYMPTOMS.  Besides the three cardinal symptoms—struma, tachycardia and exophthalmus—there are

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