The Head and Neck 107 



not to include a veinlet which receives branches from the lobe at 

 this level. If necessary, a portion of the lobar tissue may be in- 

 cluded. Finally, remove the lobe. There is only a slight oozing of 

 blood during the operation. 



Moussu found it very difficult to preserve the veinlets, which are 

 necessary for the proper performance of the parathyroid function. 



Gley and Nicolas found that the glandules underwent hyper- 

 trophy after extirpation of the gland. 



Breisacher noticed that dogs fed on raw meat suffered more 

 acutely from thyroidectomy than those fed on milk and boiled meat, 

 and Victor Horsley observed that a vegetarian diet was that which 

 led to the fewest symptoms after thyroidectomy. Moreover, gram- 

 nivorous species do not show acute symptoms after extirpation. 



EXOPHTHALMIC GOITER. 



This disease is extremely rare. It has been observed by Fried- 

 berger and Froehner, Albrecht, and Jewsejenko. It is believed to 

 be a toxic condition dependent upon hyperactivity or perversion of 

 thyroid function. It is characterized by three principal features, 

 viz., thyroid enlargement, extreme protrusion of the eyeballs with 

 immobility or retraction of the lids, and cardiac palpitation. 



Symptoms and Diagnosis. The disease is ushered in by palpita- 

 tions which generally appear consequent upon some physical or 

 mental shock, such as prolonged exercise, violent emotions, or fright. 

 Its evolution is ordinarily slow and may be interrupted with epilep- 

 tiform paroxysms (Jewsejenko). In very young animals restless- 

 ness, whining, occasional spasms, arh)^hmical pulsations and general 

 unthriftiness are apparent. The glandular enlargement is soft and 

 elastic and uniform in both lobes or is more pronounced in one than 

 in the other. The bulging of the eyeballs is so acute that disloca- 

 tion appears imminent. The cornea is usually ulcerated. Besides 

 these symptoms others may make their appearance, viz., trembling of 

 the extremities, anorexia, emaciation, pruritis, and subcutaneous ab- 

 scesses. 



Treatment. Iodine medication internally and externally is indi- 

 cated, together with administration of digitalis to combat the cardiac 

 irregularity. A case which terminated in complete recovery was 

 treated by local disinfection of the eyes, and inunction of belladonna 



