GOITER— STRUMA— BROXCHOCELE o45 



Diagnosis. —The diagnosis is not difficult when all the 

 symptoms are taken into consideration. A differential 

 diagnosis should be made from the other forms of goiter, 

 but aside from vascular goiter this should be easy. In 

 vascular goiter the general symptoms are usually absent. 



Prognosis. — Not considered favorable. Some cases recover 

 rapidly under proper treatment.. 



Treatment.— Owing to the hyperthyrea present, iodin 

 preparations and thyroid extract are contraindicated. The 

 treatment indicated is the reduction of the hyperactivity 

 of the thyroid glands, and regulating the heart action. The 

 hyperactivity of the glands is best controlled by ligation of a 

 portion of the blood supply to them which will immediately 

 stop the function of that particular part and reduce the total 

 volume of secretion. It is recommended that the anterior 

 arteries be ligated. This should be done under strict anti- 

 septic precautions and morphin anesthesia. Immediate 

 good results are obtained in many cases. Extirpation of a 

 portion of the gland is often done in the human subject but 

 is not so practicable in animals. The heart action should 

 be controlled by small doses of digitalis fluidextract (0.1 to 

 0.2 twice daily), or aconite tincture (0.1 to 0.2 two or three 

 times daily). The animal should be kept in a quiet place. 

 Other conditions arising must be treated accordingly. 



