THE TllYi;<ill> .WD PABATHYBOID QLAND8 757 



quenl in women than in men, a fact of significance when we recall the 

 evidence of association between the thyroid gland and the generative 

 organs. It is said that the disease is usually coupled with persistence of 

 the thymus gland. The thyroid gland in exophthalmic goiter is enlarged, 

 sometimes in one Lobe; it is hard and pulpy, and on auscultation a mur- 

 mur is heard. Histologically the gland presents a picture very like 

 thai which has been described above as hyperplasia; thai is to say, the 

 vesicles have a deficiency of colloid material: their epithelium is colum- 

 nar and folded up into t he vesicles; and the interstitial tissue betw< 

 the vesicles is very markedly increased. 



Exophthalmic goiter is almosl universally claimed to be due to hyp< 

 secretion of the thyroid, because: 1 the symptoms of the di ire not 



unlike those produced by excessive administration of thyroid to a normal 

 individual: and (2) they are in general opposite in character to the symp- 

 toms found in rases where the thyroid gland is atrophied. The blood of 

 a person with exophthalmic goiter when inject* d into mice increases their 

 resistance to the toxic action of acetonitrile, which is also the Eter 



thyroid extract has been injected. In many cases of exophthalmic goiter 

 partial removal of the gland is said to ameliorate the symptoms. Other 

 clinicians, however, state that if the patient is given proper medical 

 treatment, rest, and diet, equally beneficial results can be obtained. 



Certain investigators, however, deny that it has yet been conclusively 

 demonstrated that exophthalmic goiter is due to hypersecretion of the thy- 

 roid .Marine . It is pointed out that, if hypersecretion were the cause of 

 the disease, one would expect thai the injection into animals of the hi I 



of patients suffering from ii would produce symptoms similar to tl 

 following the injection of thyroid extract. The results of such experi- 

 ments, however, have been extremely confusing and very indecisive, since 

 it is difficult to recognize in laboratory animals many of the characteru 

 symptoms, especially those affecting the skin and eyes and the gen< 

 bodily nutrition. Another difficulty in accepting the hy] m hypoth- 



esis is the fact that an extrad of a gland removed from an exophthalmic 

 patient has no differenl physiological action on a normal animal from an 



extrad of a normal gland containing the same percentag ; odine. 



The evidence is by no means conclusive one way or the other, and it may 

 well he that the observed changes in the thyroid gland are not tin 

 of the symptoms of exophthalmic goiter, hut merely, like th- symp- 



toms of this disease, a resull of Borne condition loc re. 



The Relationship of the Thyroid with Other Endocrine Organs 



1. With the Generative Organs. Evidence of an association between 

 the female generative organs and the thyroid is very strong; thus, the 



