CHAPTER V 



INTERNAL SECRETIONS 



Thyroid Gland. On either side of the windpipe, rather below 

 the thyroid cartilage (Adam's apple), lies a somewhat conical 

 mass of tissue. The two masses are connected by an isthmus ; 

 lobes and isthmus make up the thyroid gland. The whole 

 weighs about an ounce. In health it is so soft that only the 

 finger of an anatomist could detect it through the skin and the 

 thin flat muscles which connect the hyoid bone and the thyroid 

 cartilage with the breast-bone. It makes no visible prominence 

 on the front of the neck. The thyroid gland is, however, 

 liable to enlargement, especially amongst the people who live 

 in certain districts. In the Valais, " goitre," as it is termed, 

 is so frequent that anyone walking up the Rhone Valley is 

 sure to meet a number of persons for the most part women 

 whose swollen necks overhang their collar-bones, like half- 

 filled sacks. Goitre is even more common in the Valle d'Aosta, 

 on the Italian side of the Alps. In England this condition, 

 comparatively rare, is known as " Derbyshire " or " Hunting- 

 donshire " neck. 



In the majority of cases the tumour in the neck develops 

 slowly, and does not reach its full dimensions until after 

 middle life. Goitre in this form, although inconvenient, 

 causes no serious discomfort. But when it appears in early life, 

 it is associated with an extraordinary complex of malforma- 

 tions and ill-performed functions. The condition into which 

 a goitrous child sinks is known as cretinism. With the 

 exception of the skull-case, its skeleton does not attain to its 

 proper proportions ; and, since the soft parts do not equally 

 submit to arrest of growth, the dwarf is heavy and ungainly, 

 with large jowl and protuberant abdomen. The appearance 



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