404 RESULTS OF EXTIRPATING THE THYROID GLAND. 



strated that, although one-twentieth the size of the brain, the thyroid 

 has as large arterial vessels. Horsley testifies to its important secretory 

 functions, and points out that myxoederna does not appear, if half or a part 

 of the gland be left. Others (Munk) believe that the disturbances caused 

 by extirpation result from unfavourable wound healing, or from injury 

 to the vagus or sympathetic, and moreover are aggravated by feeding 

 the patients on flesh. Breisacher tested this question by a series of 

 experiments on dogs, and found that the strumous symptoms, especially 

 the clonic and tonic muscular contractions, and respiratory cramp receded, 

 when the animals were restricted to milk diet, but reappeared when 

 they were again fed on meat and soup ; boiled meat, however, appeared 

 not to be injurious. 



Other dangers of extirpation are the risk of injuring the recurrent 

 nerve or vagus, and of causing dangerous bleeding. Massot removed 

 the thyroid in two horses without bad results, and in one of them 

 the dyspnoea consequent on pressure disappeared after operation. 

 Moller once performed the operation in a horse without the results 

 described, but operating on dogs he repeatedly observed cachexia 

 strumipriva. Removal of a portion of the gland is, however, not 

 attended with serious consequences. Haubner stated that lambs 

 affected with goitre were sometimes born dead, sometimes died 

 soon after birth. A lamb operated on by Haubner remained healthy, 

 though for how long is not said. Carcinomatous goitre can be 

 recognised by the uneven, knotty character of the surface of the 

 swelling. It is very dangerous. 



Treatment. Medicines administered internally, or applied by 

 infriction, are usually without success ; but iodide of potassium 

 may be prescribed or used as ointment. Painting with tincture 

 of iodine has been recommended, but this is only serviceable 

 when the thyroid is acutely swollen in consequence of disease 

 of the pharyngeal mucous membrane. Siedamgrotzky suggests 

 infriction with iodoform and unguentum hydrarg. Truelsen 

 recommends rubbing in three times a day an ointment of 1 part 

 of pure iodine, 5 parts iodide of potassium, 30 parts sapo virid., and 

 gives internally iodide of potassium and nitrate of potassium in 

 doses of 30 grains of each. A marked diminution of the swelling 

 and removal of the dyspnoea is said to occur in three weeks. In 

 true goitre more active results are obtained by parenchymatous 

 injections made with a Pravaz syringe, the needle being inserted 

 into the tissues of the gland, and from 5 to 15 drops of tincture of 

 iodine passed in. Inflammation usually develops, but disappears 

 in eight to fourteen days, when the injection may again be used 

 and repeated at intervals. Good results have been reported from 



