The three knights of thyrotoxicosis

Of the three physicians who described thyrotoxicosis, Karl Adolph von Basedow is the least known, especially in the English-speaking world. Born at Dessau in 1799, Basedow studied medicine at Halle University, worked as a physician in various cities of Germany, and in 1835 was appointed Director of the Clinic for Internal Medicine at the University of Kiel. In 1840 he published a paper on “Exophthalmic goiter, manifested by goiter, protrusion of the eyes, and other symptoms such as tremors, anxiety, and heart palpitations”. He received many honors, was awarded the prestigious membership of the Prussian Academy of Sciences in Berlin, and became chief physician at the Royal Hospital in Hanover (1856).1

If you developed thyrotoxicosis in most parts of Europe, people would say you have Basedow. But in the English-speaking world you would have had Graves’ disease—named after the Dublin physician Robert James Graves (1796–1853), who described the disease in 1835. Graves was the leader of a school of diagnosis that emphasized clinical observation and advocated not starving ill patients. Graves himself desired to have as his epitaph “he fed fevers.”2

Priority, however, belongs to the Gloucestershire-born Caleb Parry, who practiced in fashionable Bath late in the eighteenth century. Many of the patients described by Jane Austen or Josiah Smollett would have called on him after taking the waters at the Pump Room. In 1786, Parry observed the first of what would total five cases of exophthalmic goiter later published posthumously under the title “Enlargement of the Thyroid Gland in Connection with Enlargement or Palpitation of the Heart” in 1825.3 Accordingly, some physicians have argued that the disease should be called Parry’s disease. Others feel that the days of eponymity have well passed and that diseases should no longer be described by whoever described them.4,5

 

Slide from a 29-year-old woman with untreated hyperthyroidism, goiter, and dysphagia. “Diffuse Thyroid Hyperplasia” photo by Ed Uthman on Flickr. CC BY 2.0.

 

 

References

  1. Karl Adolph von Basedow. Wikipedia. https://en.wikipedia.org/wiki/Karl_Adolph_von_Basedow.
  2. Pearce, JMS. Robert James Graves MD FRS. Hektoen Int Physicians of Note (Spring 2022). https://hekint.org/2022/05/23/robert-james-graves-md-frs/.
  3. Pearce, JMS. Caleb Hillier Parry MD FRS. Hektoen Int Physicians of Note (Spring 2022). https://hekint.org/2022/05/05/caleb-hillier-parry-md-frs/.
  4. Gill, D. Doctors like eponymity. Hektoen Int History Essays (Winter 2011). https://hekint.org/2017/01/30/doctors-like-eponymity/.
  5. Pearce, JMS. Naming diseases. Hektoen Int Ethics (Winter 2012). https://hekint.org/2017/01/30/naming-diseases/.

 


 

Winter 2023  |  Sections  |  Physicians of Note