While numerous writers1 have reported on hypothyroidism in the practice of otolaryngology, nevertheless, from the number of cases seen in an average otolaryngologic practice in which this condition had been diagnosed as neurasthenia, anemia, hypotension, sinus disease, allergy or vitamin deficiency I have come to believe that many otolaryngologists carry a mental picture of myxedema or cretinism rather than of incipient hypothyroidism. This is a mild atypical condition that may be seen in patients of any age.
It is not my purpose to discuss myxedema or cretinism, for the symptoms and findings in those conditions are well known, but rather the marked variations in the clinical picture that are all too frequently overlooked. In these milder states hypometabolism tends to exert a selective action on only one—or possibly several—of the organs and systems.
Briefly, the physiology of the thyroid gland is that it produces a hormone which has a definite