XXXVII.— EXOPHTHALMIC GOITRE. 



At the beginning of the present week I specially retained in hospital 

 a horse showing certain curious symptoms, to which I drew your parti- 

 cular attention. The animal was about fifteen years old, and had been 

 its present owner's possession for five months. Until the last few days 

 it had enjoyed good health and done regular work. We were informed 

 that it then left a part of its food, that the faeces became small in 

 quantity and hard, and that the animal seemed less active at work. 



In this patient we immediately noted a two-lobed swelling formed 

 by enlargement of the th3Toid gland, and situated opposite the origin 

 of the trachea : the left lobe was larger than the right. Both lobes 

 were soft, elastic, resistent, slightl}- fluctuating, moveable under the 

 skin, and somewhat adherent to the deeper seated tissues. The mouth 

 was dry, but there was no dental disturbance. Palpation of the 

 abdomen was not painful, and no signs of obstruction of the intestine 

 could be detected. 



There was no tachycardia (rapid action of the heart), no palpitation, 

 no intermittenc}- ; in fact, no other trouble. The respiratory moAC- 

 ments were not accelerated. The temperature hardly registered 38'^'^ 

 C. (ioi'3° F.). Having noted these points you saw that I examined 

 the eyes in order to judge of their size and prominence. In the letter 

 sent me "slightly pronounced abnormal prominence of both eyes" 

 was mentioned. In point of fact there was no \isible exophthalmia. 

 Although the animal showed goitre and a cardiac murmur its want of 

 appetite was due entirely to enteritis. It was certainly not suffering 

 from exophthalmic goitre. Ne\ertheless, since I have brought the 

 question before you, I shall not allow it to pass without describing to 

 you in what exophthalmic goitre consists. 



In human medicine, for rather more than half a century, there has 

 been described under the titles of exophthalmic goitre. Graves' disease, 

 and Basedow's disease a morbid condition, the exact nature of which 

 is still little understood, but which is clearU- distinguished h\ three 



