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Who first described GRAVES DISEASE?
GRAVES DISEASE is an autoimmune condition characterised by diffuse hyperplasia of the thyroid gland, excessive secretion of its thyroid hormones and increased metabolic rate.
By: Ailesbury Media
Robert Graves, the son of an episcopal clergyman was born in Dublin in 1797, the same year that Napoleon was leading his armies over the Alps to threaten the citizens of Vienna. He was a brilliant student and graduated with a first class medical degree in the fall of 1818 as Abraham Lincoln’s mother Nancy, lay dying of ‘milk fever’ in a small wooden hut in the untamed forestlands of Indiana. It appears that as well as being an excellent scholar, Graves was also a passionate adventurer and often told his medical friends that ‘there was always something waiting to be discovered if we only took the time to look for it’. It is therefore of no surprise that when Graves completed his medical studies he decided to further his knowledge of the Arts by travelling overland on the continent. Let us remember that this was the European mainland of the 1820’s and a lot of the continent was still considered alien to most people on these islands. The perception of the ancient palaces of Rome or maybe the evening mist settling on the sleepy canals of Venice were often images snatched from lines of poetry or from the canvases of travelling painters. Many people of this period were highly suspicious of strangers who were often considered to be displaced soldiers wandering around after the recent battle of Waterloo. It was in a little lakeside Austrian village that Graves eventually aroused the distrust of the locals and he was arrested and held as a Prussian spy. It appears that the local authorities refused to believe that an Irishman could speak German so well and the unfortunate scholar had to stay in jail for ten days before he could get verification of his identity sent from Dublin. In 1821, Graves was travelling alone in Switzerland and found himself staying in the same hotel as the famous English painter, J.M.W. Turner. Both men struck up a friendship and they travelled and painted together for many months before finally parting company outside the Vatican in Rome. Many of Turner’s famous storm scenes come from that period of his life and often show dreary afternoon skies heavily streaked with dark cautioning thunderclouds. It is surmised by some that Robert Graves may have been the physical inspiration for one of Turners more imposing storm paintings, The Fishermen at Sea.
In this picture the inky blackness of the night is gathering fast and a sliver of a white moon shows a fishing vessel being tossed and thrown about at sea. It is known that Graves once was caught in a violent storm while on a sailing ship on the Mediterranean. The vessel was at the mercy of a raging tempest and suddenly began to take on water and sink. The bilge pumps were leaking and the crew found themselves unable to save the stricken craft. Amidst the frenzy of the thunderous storm the crew mutinied and abandoned ship by stealing the only lifeboat that was aboard the stricken vessel. Graves was incensed and refused to allow himself or his fellow passengers to be left to the peril of the seas. He ran forward and grabbed a nearby fire axe and holed the lifeboat as the mutinous sailors lowered it into the turbulent waters. He then gathered leather from the shoes of the passengers and proceeded to fix the bilge pumps. The ship was sailed into port the next morning and everybody on board was saved.
Graves returned to Dublin in 1821, in the year that Napoleon died on a small British outcrop of rock in the south Atlantic, and he became chief physician at the Meath Hospital. He continued his idea of believing that ‘everything was waiting to be discovered if you only look for it’ and before long he had described hyperthyroidism, scleroderma, pontine haemorrhages, angioneurotic oedema as well as pathological fractures and the paraneoplastic syndrome, erythromelalgia. He was also a great teacher and taught in English, which was unusual and most medical classes in the 1820’s still taught their pupils in a sort of Latin and his clinical notes were used by Trousseau (Trousseau’s sign) in Paris in 1825. When Trousseau wrote a clinical text some years later it was translated into English and used in Dublin. Graves became a good friend of William Stokes and also became passionate about the introduction of the stethoscope into clinical examination of the chest and abdomen. They both shared ward rounds in the Meath Hospital and often spent long hours teaching medical students the signs of illness. In the midst of a busy round Graves once joked to his residents that Stoke's’ epitaph should be ‘He fed fevers’. He died in 1853, as Guiseppe Verdi’s Il Traviata was having its premiere in La Scala in Milan. I often feel sad that people like Robert Graves are not alive today as they certainly would brighten the world of Irish medicine and enjoy the clinical benefits we now possess. Maybe somebody will remember one of our present consultants in a century and a half from now in the highly technologised society our own children will help to create.
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Dr. Patrick Treacy is Medical Director of Ailesbury Clinics Ltd. He is Chairman of the Irish Association of Cosmetic Doctors. He is a Medical Advisor to the website Consulting Rooms. He wrote a Medical History series in 1999 for the Irish Medical TImes