logical order, as illustrating the slow growth of a certain phase of inductive science.
II
On the continent of Europe, the disease "exophthalmic goiter" is variously known as "Basedow's disease," or morbo di Flajani, after the two observers who in Germany and Italy are thought to have originally described it. Basedow, a physician of Merseburg, published, in 1840, a description so complete that the Germans regard it as the classical one. The three symptoms which he signalized—swelling of the thyroid gland, protrusion of the eyeball and palpitation of the heart—the Germans sometimes call the "Merseburg triad,"[1] which they also designate by the simple telegraphic epithet "Basedow." Among English-speaking people, exophthalmic goiter is usually known as Graves's disease, after the well-known Irish clinician who printed an accurate account of it in 1835. But more than fifty years before Basedow, Caleb Hillier Parry, an eminent physician of Bath, England, made a notation of all phases of the Merseburg triad, part of which deserves citation, if only on account of its historic interest.
Enlargement of the thyroid gland in connection with enlargement or palpitation of the heart.—The first case of this coincidence which I witnessed was that of Grace B., a married woman, aged thirty-seven, in the month of August, 1786. Six years before this period she caught cold in lying-in, and for a month suffered under a very acute rheumatic fever; subsequently to which she became subject to more or less of palpitation of the heart, very much augmented by bodily exercise, and gradually increasing in force and frequence till my attendance, when it was so vehement, that each systole of the heart shook the whole thorax. Her pulse was 156 in a minute, very full and hard, alike in both wrists, irregular as to strength, and intermitting at least once in six beats. She had no cough, tendency to fainting or blueness of the skin, but had twice or thrice been seized in the night with a sense of constriction and difficulty of breathing, which was attended with a spitting of blood. She described herself also as having frequent and violent stitches of pain about the lower part of the sternum.
About three months after lying-in, while she was suckling her child, a lump of about the size of a walnut was perceived on the right side of her neck. This continued to enlarge till the period of my attendance, when it occupied both sides of her neck, so as to have reached an enormous size, projecting forwards before the margin of the lower jaw. The part swelled was the thyroid gland. The carotid arteries on each side were greatly distended; the eyes were protruded from their sockets, and the countenance exhibited an appearance of agitation and distress, especially on any muscular exertion which I have rarely seen equalled. She suffered no pain in her head, but was frequently affected with giddiness. [After outlining his scheme of treatment, Parry concludes:] From this time no further application was made to me respecting this patient, who probably soon paid her debt to nature.
Between 1786 and 1815, Parry collected eight cases of this malady, which were published after his death, in 1825.[2] He undoubtedly is en-
