THY 



T H Y 



Alfo, a place fituatcd on the coaft of the Pcloponncfus. 

 According to Herodotus, the inhabitants of Hermionegave 

 it to thofe of Samos. 



THYREUM, a fmall town of Arcadia, S. of Megalo- 

 pohs. It was deferted in the time of Paiifanias. 



THYRIDES, a town of Laconia, S.E. of Meifla. 

 Near this phicc were the ruins of the town of Hippola, in 

 the midft of which was fecn, in the time of Panfanias, a 

 chapel of Minerva Hippolai':is. — Alfo, the name of the 

 fummit of Txnarus, in the Peloponncfus ;■ 30 ftadia from the 

 promontory Taenarum. Pliny gives the name of Thyrides 

 to three iflands of the gulf Afinaeus. 



THYROID, in Anatomy, thyroideus, or more properly 

 thyreoldtus, from 9uf !(/u?'>i<, compounded of Sup so;, ajhield, and 

 uh:, form ; a name given to one of the cartilages of the 

 larynx (foe Lakynx), to a gland fituated near that carti- 

 lage (fee Larynx), and to the arteries and veins of the 

 gland. See Aiitery and Vein. 



Thyroid Gland, D'lfcafcd. See Bronciiocele. 



Thyroid Gland, Extirpation of. It cannot be doubted 

 that this operation is one of the moll difficult and danger- 

 ous in tlie practice of furger\' ; and it ought never to be 

 undertaken, except under the moll urgent circumftances, and 

 by operators of confuinmate (kill and judgment. Were a 

 furgeoh, fuperficially acquainted with anatomy, and little 

 accuilomed to attempts of fo bold a kind, to undes-take the 

 operation of cutting away a difeafed thyroid gland, he 

 would run the utmoft ride of feeing the patient bleed to 

 death under his hands. 



The following is a memorable inftance of the fuccefsful 

 performance of this operation. In the year 1784, J. Hyons, 

 twenty years of age, experienced an acute pain at the mid- 

 dle and anterior part of the neck, in confequence of a 

 violent extenfion of the head. This pain, which was only 

 momentary, was followed by fome difficulty of motion. 

 About three months afterwards, a fmall, hard, indolent 

 tumour appeared on the right fide of the trachea. Tlie 

 fwelling was unattended with pain, or alteration in the 

 colour of the integuments. The tumour feemed to be raifed 

 by a pulfatory aftion, which tended to prove the exiftence 

 of a large arten,- underneath, and, in faft, its bafe was 

 fituatcd on the general courfe of the carotid artery. The 

 patient feeling no inconvenience, neglected it until June 

 1788. At this time it was an inch in diameter. Its pro- 

 grefs, which in the firft inilance was flow, now augmented 

 with proportionable rapidity. Internal remedies and topi- 

 cal applications had no effeft in preventing its increafe. 

 A fluftuation in its centre was foon evident : an incifion 

 was then made into this part, and a quantity of yellow fe- 

 rofity difcharged. Three months after this operation, 

 which was not of the lead fervice, recourfe was had to 

 eauftics, which were repeatedly applied without any ad- 

 vantage. On the 20th of March 1791, (lie prefented herfelf 

 for admiffion at the Hotel-Dicu. At this period the tu- 

 mour was two inches in diameter, round, hard, and at- 

 tached to the right and middle part of the trachea, and it 

 pufhed outwards the fterno-maftoideus mufcle. Independ- 

 ently of its being feniiblv raifed by each pulfation of the ar- 

 teries, it obeyed the motions of deglutition, and in a flight 

 degree impeded the paffage of the folid aliment. The pa- 

 tient; , -neftly defiring to get rid of fo inconvenient a de- 

 formity, .elermined to fubmit to its extirpation, which ap- 

 peared her only rcfource. The danger, the length of time, 

 and the pain neceffarily annexed to the operation, were not 

 concealed from her. The operation, after a few days pre- 

 vious preparation, was performed in the amphitheatre by 

 Default in the following manner : the patient being laid on 



her back, a little inclined on the left fide, with the bead and 

 neck more raifed than the reft of the body, the (urgeoii 

 made a longitudinal inciCon through the middle of the 

 tumour, beginning one inch above, and finiftiing one inch 

 below, to allow room to finifti the operation with eafc : in 

 the firft fcftion he cut down as far as the gland, dividing 

 the integuments, the platyfma-myoides, and fome fibres of 

 the fteriio-tiyoideii and fterno-thyroideii mufcles ; an afCft- 

 ant, with the view of fixing the tumour, drew towards the 

 left the infide edge of the wound made by the incifion, 

 whilft the furgeon detached it from the fterno-maftoidcui; 

 mufcle. In didefting the cellular fubftance which united 

 the parts, two fmall arteries were divided, which were raifed 

 by a pair of differing forceps and fecurcd by ligatures. 

 The external fsrface of the tumour being thus difengaged, 

 the internal part was detached in the fame way. The 

 tumour was drawn outwards by means of a hook, that it 

 might be feparated with more eafe from the anterior part 

 and from the fide of the trachea. In the courfe of this dif- 

 feftion, the branches of the thyroid arteries were fuccef- 

 fively tied, as faft as they were divided. The affiftant, to 

 whom the hook was confided, dircAed the gland from 

 within and forwards, whilft the furgeon finiftied the diflec- 

 tion outwards and from above downwards. This part of 

 the operation was the moft minute and difficult : it was ne- 

 ceftary by means of a fponge continually to wipe away the 

 blood, which neceflarily prevented the parts from being 

 eafily diftinguiftied, and obliged the furgeon to divide but a 

 little at a time, and previoufly to feel with his finger thofc 

 parts he was about to incife. By this cautious difftiftion of 

 parts, the fuperior and inferior thyroid arteries were laid 

 bare, and afterwards fecured by ligature by means of a 

 blunt crooked needle. They were afterwards tranfverfcly 

 divided, and the remaining part of the tumour detached 

 from the trachea, to which it ilrongly adhered. The wound 

 refulting from this operation was near three inches in depth : 

 it was outwardly bounded by the fterno-maftoideus mufcle, 

 and inwardly by the trachea and ccfophagus ; pofteriorly 

 by the carotid artery, and by the nerves of the eighth pair, 

 which were expofed at the bottom of the wound. After 

 the wound was well wafticd with warm water, and cleared 

 from the blood, it was filled with coarfe lint, powdered with 

 colophony ; fquare compreftcs, fecured by a bandage mo- 

 derately tight, formed the reft of the drefling. The extir- 

 pated tumour was five inches in circumference ; and on ex- 

 amination was found to differ in no particulai" from fchirrous 

 glands, except that in the centre there was a cartilaginous 

 nucleus. The patient fupported this long, difficult, and 

 painful operation with uncommon firmnefs : fhe paffed the 

 reft of the day without experiencing any other fymptom 

 than a flight fhivering, generally confequent to large wounds. 

 The following night (he complained of a fenfe of heat in 

 the neck, and fome difficulty in deglutition. The next day 

 a little eafe was obtained by moillening the dreffing with a 

 decoction of marfhmallows. A weak drink of the herb 

 dog's-tooth, acidiJated with oxymel, was prefcribed. On 

 the third day the fever was very moderate, but the difficulty 

 in fwallowing had confiderably increafed at this period ; the 

 compreffes and the external hnt were removed, and frefti 

 apphed. On the fourth, the fever ceafed, and deglutition 

 became lefs painful. Suppuration now became eftablifhed. 

 The next day all the hnt was detached, and the whole of 

 the dreffings renewed. The wound was in a good ftate : it 

 was di-effed with foft Hnt and coinpreftes moiftened with an 

 emollient decoclion ; a pradlice which was continued for 

 the following days. No particular circumflance occurred 

 during the cure. The \\«ound followed the ordinary pro- 

 4 H 2 grefs, 



