JAMA. 1890;XV(15):538-539. doi:10.1001/jama.1890.02410410018002.
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A CASE OF EXOPHTHALMIC GOITRE.  A Clinical Lecture delivered at the Hospital of the University of Pennsylvania.BY JAMES TYSON, M.D.,PROFESSOR OF CLINICAL MEDICINE.Our patient, a woman, aged 44, was born in Ireland, and is a servant by occupation. Her family history has no bearing on the present disease. Up to three years ago she had good health; at this time she became ill with rheumatism and was confined to her bed for a month. She recalls her knee as being badly swollen. At this time, too, she noticed for the first time a lump growing upon the front of her neck, first in the median line. With this she experienced a choking sensation, especially when she swallowed; but occasionally at night, when lying down, she noticed the same disagreeable symptom. At first the swelling increased slowly, but for the last year it has grown rapidly. As early


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