History: Thyroid

Hypothyroidism was first described by Gull in 1874. "Myxoedematous madness" was noted in a report of a committee of the Clinical Society of London in 1883, but best known from the report by Richard Asher in British Medical Journal in 1949. Asher said he first learned of the condition in a novel, The Citidal, by AJ Cronin, in which the hero, Dr. Andrew Manson, describes a patient in the following way,

"at first he hardly recognizes him. The change was not gross...but...his features coarsened in some subtle way. His face seemed swollen, his nostrils thickened, the skin waxy, except for a faint reddish patch that spread across his nose. His whole appearance was heavy, apathetic...He muttered unintelligibly Then, clenching his fists, he came out with a tirade of aggressive nonsense.

...Manson instinctively reached out and touched the swollen face, noting subconsciously, as he did so, that the pressure of his finger left no dent in the oedematous cheek...

All at once, electrically a terminal vibrated in his brain. Why didn't the swelling pit on pressure? Because--now it was his heart which jumped!--because it was not true oedema but myxoedema...

Yes, the skin was dry and rough, the fingers lightly thickened at the ends. Temperature--it was subnormal. Methodically he finished the examination, fighting back each successive wave of elation. Every sign and every symptom, they fitted as superbly as a complex jigsaw puzzle. The clumsy speech, dry skin, spatulate fingers, the swollen inelastic face, the defective memory, the attacks of irritability culminating in an outburst of homicidal violence..."

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