Three Cases of Adult Myxedema in Women, Reported for the Purpose of Calling Attention to Their Widely Different Symptomatology and Clinical Findings:

Geographical peculiarities, such as altitude, latitude, climate or geological formation apparently have no influence on the incidence of adult myxedema. Indeed, Falta states that typical myxedema seems to be relatively rare in districts where goiter is endemic, and Dock mentions its infrequency in Derbyshire, the traditional home of goiter in England. Several American writers have stressed the fact that the disease is almost invariably incorrectly diagnosed and the patient passes through the hands of several consultants before myxedema is recognized. The experience of Anders, Plummer and the writers substantiate this. Moffitt many years ago collected 83 cases in California; many are never reported and many more are never recognized. The disease is probably scattered fairly evenly throughout the world, and impressions of preponderance in certain localities are apt to originate from the fact that a few physicians in these regions have been sufficiently alert to have collected many cases and placed them on record.