The Head and Neck 103 



through dark yellowish to perfectly clear serous fluid. (Cystic 

 struma) . 



Blood may also be extravasated into and infiltrate the con- 

 nective tissue adjacent to the gland, or even of the entire length of 

 the Jieck (Hemorrhagic struma). 



Sometimes thick septa of the interstitial connective tissue de- 

 velop with consequent atrophy of the vesicles (Fibrous struma). 



A very rare form of osteochondroma (Osseous struma) has 

 been observed by both Siedamgrotzky and Kitt, and I have also wit- 

 nessed the same condition in an aged Collie female. There was unil- 

 ateral enl?irgfement fully the size of the subject's own cranium. The 

 gladular tissue had almost completely disappeared, a few minute 

 isolated cysts and cell clusters marking the areas of functional per- 

 sistence. 



Malignant neoplasm (Malignant struma) not uncommonly 

 affects old animals. It is usually of carcinomatous character. Ac- 

 cording to Kitt, sarcoma has never been observed for a certainty, 

 but Cuille and Sendrail have recorded an instance and referred to 

 another case witnessed by Lienaux. Wells, Loeb, and others have 

 recently published observations indicating that not infrequently a 

 curious mixed tumor may form, in parts sarcoma, and in parts car- 

 cinoma. Malignant struma tends to infiltrate neighboring structures 

 and to lead to formation of secondary growths in the veins and in 

 the lungs by way of the veins and lymphatics and also within the 

 bones. 



Symptoms and Diagnosis. The effect on the organism of the 

 different forms of goiter varies according to the nature, size, and 

 position of the growth. Some of the largest simple goiters hardly 

 affect the animal other than to render him unsightly. On the other 

 hand, quite insignificant growths have been known to produce seri- 

 ous respiratory disturbances, with spasm of the glottis, owing to 

 compression of the vagus and sympathetic nerves. Very voluminous 

 goiters may induce suffocation by causing a narrowing of the 

 lumen of the trachea and larynx. This is true also of the hemorr- 

 hagic form. Siedamgrotzky saw the esophagus completely encircled. 

 Moeller has seen dogs with enormous goiters unable to lie down 

 on account of the pressure on the trachea induced by that act. Van 

 Gemmern and Mecke saw vomiting (probably reflex) induced in a 

 one-year-old Italian greyhound when the gland was enlarged, which 



