That myxedema is not a disease per se, but a symptom, or collection of symptoms, dependent upon the absence, or upon a diseased condition of the thyroid gland, is now generally accepted to be a fact, the degree of severity of the symptoms depending upon the extent to which destruction of the secreting portion of the gland in question has taken place. That cretinism, myxedema and goiter (so-called) are but variations of the one disease, is a view that is gaining adherents, as closer study into these conditions reveals the similarity in many of their symptoms, and the excellent results obtained in their treatment by the same therapeutic means. Sir William Gull1 first defined myxedema as ''a cretinoid state supervening in adult life in women," and drew attention to the similarity between myxedema and cretinism, expressing his opinion that both are allied. Ord2 and others have also pointed
BIERHOFF F. THE RECOGNITION AND TREATMENT OF EARLY MYXEDEMA IN CHILDHOOD. JAMA. 1898;XXXI(21):1208–1211. doi:10.1001/jama.1898.92450210009002c
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