Myxedema:  A Reevaluation of Clinical Diagnosis Based on Eighty Cases

AMA Arch Intern Med. 1959;104(2):234-241. doi:10.1001/archinte.1959.00270080060007.
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From the earliest descriptions of cretinism by Paracelsus1 and Platerus2 until the definitive contributions of Curling3 and Gull,4 in the late 19th century, a great morass of superstition, ignorance, and error had been gradually conquered. Correlation of thyroid atrophy found at autopsy with the clinical state, myxedema,5 and subsequent successful treatment of this condition with a glycerin extract of sheep thyroid 6,7 provided physicians with one of the most reliable approaches to the complete control of an otherwise crippling disease. It is indeed a paradox that, despite our increasing knowledge of basic thyroid physiology and the development of progressively more accurate assays of thyroid function, recent emphasis is being placed on diagnoses of "hypothyroidism" and the even more obscure entity of "idiopathic hypometabolism," while clear-cut myxedema continues to go unrecognized.

Previous reviews, by Means and Lerman 8 and by Lerman,9 have emphasized the subtle onset, diverse symptomatology, and diagnostic pitfalls


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