CLINICAL SYNDROMES (STATUS THYMICUS, ETC.) 421 



lower part of the wound could be seen, rising and falling with each respira- 

 tion the upper portion of the thymus, resembling very closely in color and 

 structure the omentum seen through a thin hernial sac. 



The gland when first seen was inside its capsule which was lifted up 

 and encised. Further resembling the omentum, the gland showed a. ten- 

 dency to herniate through the capsule at each expiration, when it was 

 seized with a forceps and gradually stripped of its investing sheath, until 

 the larger portion was extrathoracic, when it was tied off at its more fixed 

 portion under the sternoclavicular junction, where it is joined by the 

 nutritive branches of the internal mammary artery. The wound was 

 closed with deep sutures of catgut in the cervical structures and skin 

 stitches of horsehair. 



"The temperature which wa.s normal before the operation, became 102 

 F. a few hours afterward, and 105 F. the next two days, when it grad- 

 ually went down to normal at the end of the week. Two slight convul- 

 sions occurred during the week. 



"At the end of the week the lower part of the wound was found in- 

 fected, but it drained well and caused no rise in temperature. The early 

 and rapid rise I believe occurred too soon to be due entirely to infection. 

 The further course was uneventful, no more convulsions. No more stri- 

 dor. The X-ray showed lessened density in the thymic region." 



But even Olivier and Veau (&), whose success with thymectomy has 

 been most brilliant, latterly advocate the use of the X-ray by preference. 



