292 



THE DUCTLESS GLANDS 



the symptoms of exophthalmic goitre. Dr. Marine has, how- 

 ever, observed that if these dogs be treated with iodides, tlu* 

 alveoli again become rounded and filled with colloid, and 

 according to Kocher, the administration of iodine will prevent 

 the development of the folded condition after the operative 

 extirpation of part of the thyroid. Changes in the thymus 



and lymph glands 

 seem to be common. 

 The most generally 

 accepted theory as to 

 the pathogeny of ex- 

 ophthalmic goitre is 

 that the disease is due 

 to over-activity on 

 the part of the thy- 

 roid, that an excess 

 of thyroid secretion is 

 poured into the circu- 

 lation. But Oswald 

 believes that we have, 

 in fact, a condition of 

 thyroid insufficiency, 

 since the gland is 

 often empty of col- 

 loid, and contains 

 relatively little iodine- 

 holding secretion. 

 MacCallum, on the 

 other hand, states 

 that the removal of 

 part of the thyroid 

 improves the condi- 

 tion of the patients, 

 FIG. 87. Grave's Disease (from Adami). and the administra- 



tion of thyroid 



extract makes them worse. The benefit of surgical treatment 

 is urged by several surgeons. Marine and Lenhart do not 

 believe that the thyroid changes in exophthalmic goitre are 

 either primary or specific, or that the thyroids in these cases 

 produce an increased amount of a physiologically active secre- 

 tion. On the other hand, they think that the thyroid changes 



