. The thyroid gland in health and disease. d part of this work three main factsconnected with the genesis and course of diseases of the thyroidapparatus are brought into prominence. First: That all these diseases are due to psychic, nutritional,or toxic (including microbic) factors acting eithersingly or more commonly in : That in all the pathological process is essentiallythe same—greater or lesser degrees of hyperplasiafollowed by greater or lesser degrees of fibrosis : That in all there is an alteration in the quantityand quality of the thyroid secretion di
. The thyroid gland in health and disease. d part of this work three main factsconnected with the genesis and course of diseases of the thyroidapparatus are brought into prominence. First: That all these diseases are due to psychic, nutritional,or toxic (including microbic) factors acting eithersingly or more commonly in : That in all the pathological process is essentiallythe same—greater or lesser degrees of hyperplasiafollowed by greater or lesser degrees of fibrosis : That in all there is an alteration in the quantityand quality of the thyroid secretion discharged into for the purposes of classification of these diseases we includethe inflammations with the hyperplasias due to infectious diseases,then the diseased states of the thyro-parathyroid glands, withwhich we have to deal, may be grouped as follows : — 77 (B O o g gP3 o * Oh H O ?^U r, -s g o & ^ -> g / 0-43 l>^ bjO 05 rC cS ^ IS a ^ S > p c3 CD fl in O fl +:>O &i O <D Oa2QH ft fR CD o. >;, s § s s aid -g Is J i-iseo PART III DISEASES OF THE THYRO-PARATHYROID GLANDS SECTION 1 1 ENDEMIC GOITRE Synonyms.—Struma, wen, Derbyshire neck, Nithsdale neck,branchocele. Definition.—A chronic infectious disease occurring in moreor less circumscribed areas and characterized by a non-inflam-matory and progressive enlargement of the thyroid gland, whichis unattended by marked functional disturbances. It is due tothe presence in the alimentary tract of certain undeterminedorganisms, whose toxic products reach the blood-stream andinduce in the thyroid gland hypertrophic, hyperplastic anddegenerative changes. Acting through the medium of the maternalblood, these toxins may cause hypertrophy and hyperplasia, orfibrosis and atrophy of the fcetal thyroid, thus giving rise to con-genital goitre or to the varying degrees of cretinism. Prevalence.—The extent to which goitre prevails in Euro-pean countries generally, and in the East, is seldom appre
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