126 ENDOCRINE GLANDS 



III. HYPERTROPHY OF THE THYMUS IN DISEASES 

 OF THE ENDOCRINES. 



Hypertrophy of the thymus has been noticed in simple 

 goitre, in myxedema, in acromegalia, but so far, there is 

 no proof of any relationship with these affections and 

 enlargement of the thymus. 



It is particularly in exophthalmic goitre that the fre- 

 quency of hypertrophy of the thymus has been noticed. 

 Capelle in 1908, Malti in 1912, have given operative 

 statistics which seem to show that 75% of exophthalmic 

 goitre cases which die during operation have an enlarged 

 thymus. For this reason, the majority of German and 

 American surgeons consider the action of this gland very 

 important in Basedow's disease and advise removal of 

 part of the thymus in the treatment of this condition. 



This conception is not accepted in France. Lucien 

 and Parisot have noted in Basedow's disease (as is also the 

 cases in acromegalia) that the persistence of the thymus is 

 not constant. When it does exist, the weight of the gland 

 is very variable. Experimentally, these writers were not 

 able to establish any relationship with it and the thyroid 

 or the pituitary, for thymedectomy does not result in any 

 anatomical regression or change of function of the thyroid. 

 The presence of the gland should be considered as an 

 abnormal persistence. Lenorman who has investigated 

 this condition rather carefully has shown that in exoph- 

 thalmic goitre the removal of the thymus has no more 

 effect than the administration of extract of thymus. 



These facts should, however, stimulate the clinician to 

 look for signs of thymic enlargement in Basedow's disease 

 and when found to have it treated by radiotherapy. If 

 during the course of an operation on the thyroid, an unsus- 



