It can safely be assumed that irrespective of the form of treatment advocated or adopted for sufferers from exophthalmic goiter, the uppermost immediate aim of the physician is a reduction of the heart rate to normal. Many clinical facts justify this aim. The heart bears the brunt of the damage wrought by the intensity and duration of exophthalmic goiter, and cardiac failure is the usual cause of death. The height of the heart rate and the output of blood usually parallel the severity of the other manifestations of the disease; likewise, amelioration of symptoms or recovery of the patient is announced by a calming of the heart rate and force. Indeed, so constantly is a significant behavior of the heart associated with the varying phases of this syndrome that the heart's action may be regarded as a most reliable criterion of the course of the disease during crisis, remission or
BRAM I. PHYSOSTIGMINE SALICYLATE IN THE TREATMENT OF EXOPHTHALMIC GOITER: OBSERVATIONS ON TWO HUNDRED CASES. Arch Intern Med (Chic). 1931;48(1):126–132. doi:10.1001/archinte.1931.00150010131008
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