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Article
September 1927

EXOPHTHALMIC GOITER AND THE INVOLUNTARY NERVOUS SYSTEM: XIII. THE COURSE OF THE SUBJECTIVE AND OBJECTIVE MANIFESTATIONS OF EXOPHTHALMIC GOITER IN FIFTY UNSELECTED PATIENTS. OBSERVATIONS FOR FIVE YEARS WITHOUT INSTITUTION OF "SPECIFIC" THERAPEUTIC MEASURES ("SPONTANEOUS COURSE")

Author Affiliations

NEW YORK

From the medical service of the Mount Sinai Hospital.

Arch Intern Med (Chic). 1927;40(3):314-327. doi:10.1001/archinte.1927.00130090063004
Abstract

In a previous article1 on exophthalmic goiter and the involuntary nervous system, we have recorded our observations on fifty unselected patients studied for two years. The following excerpt taken from this article will explain the system we followed in making our observations.

In January, 1921, we instituted a study of fifty unselected cases of fully developed exophthalmic goiter.2 No specific therapeutic measures were employed "in order to determine the natural history (spontaneous course) of the disease,"3 and to establish an "index for the evaluation of therapeutic procedures."4 From the group were excluded (a) patients who had thyroid enlargement without other manifestations of exophthalmic goiter,5 and (b) those who, with or without thyroid enlargement, presented sympathomimetic symptoms, without significant elevation of the basal metabolism (autonomic imbalance).6 In the group studied, we included (1) patients with a significant elevation of metabolism on repeated readings; (2) patients whose illness was sufficiently severe to

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