149 
VARIETIES OF GOITRE. 
effected by several strong assistants, or by the help of a compound 
pulley. Godine states having thus produced an extension of inches 
in the neck of a horse. Immehnann passed a strong hop sack, doubled, 
round the head of the horse, and allowed fifteen persons to pull on it. 
During extension, the operator endeavours to effect reduction by pressing 
or turning the neck at the middle of the convexity. This attempt 
generally succeeds, the distortion immediately disappearing. Busse laid 
his patient on the ground, with the concavity of the neck downwards, 
placed a board on the convex side, and exerted strong pressure on it. 
The displacement, even when reduced, may recur on the horse rising. 
In such cases fracture of the oblique process usually exists, and the 
application of a bandage is necessary. Hertwig recommended two 
splints of wood or tin, which fitted exactly the side of the neck and 
reached from the shoulder to the posterior border of the lower jaw, and 
were fastened together at the upper and lower ends of the neck by bands. 
Stockfleth recommends an iron splint (fig. 7B) constructed by Knudsen. 
Owing to its yielding nature, it is easily fitted. The splint, when applied 
to the convex side of the neck, must be padded with tow or wadding to 
prevent bruising. The horse is supported on rising, and afterwards 
fastened up short to the wall. The use of slings may be desirable. Cattle 
can be treated in the same way. The apparatus should remain in position 
eight to fourteen days, sometimes a little longer, care being taken that the 
animal does not lie down, and that the splints are kept carefully padded. 
Inflammatory processes sometimes require the use of cold applications. 
Massage may be used later to bring about absorption. Where the head 
is sunk and oedematous swellings result, producing dyspnoea by narrowing 
the nostrils, tracheotomy may be performed if necessary. Swelling 
usually disappears on raising the head and supporting it with a girth. 
IY.—GOITRE. STRUMA. 
The thyroid gland, though not so frequently the seat of disease in 
domesticated animals as in man, does become affected, especially in carm- 
vora —less frequently in horses and cattle. Acute inflammation (thyroid¬ 
itis is unknown in animals, though transitory swelling of the glands, 
without other inflammatory appearances, is seen in horses and dogs 
during the progress of catarrhal affections of the phaiynx, but disappears 
during convalescence. More frequently new growths, whose nature is 
not precisely understood, invade the glands. Hypeiplastic piocesses, 
since olden times named Struma, also occur. New growths resembling 
these develop in the gland, but being difficult to precisely identify, are 
included in the clinical term Goitre. The following varieties can 
be distinguished: — (1) Real goitre, dependent on hyperplasia of the 
