. Modern surgery, general and operative. asionally occur. Further, a goiter may be back of the sternum, that is,substernal or retrosternal. A very movable goiter, which is now above and nowbelow the sternal notch, is called a wandering or diver goiter. A goiter withinthe thorax is called intrathoracic; and such a goiter may be retrosternal, retro-tracheal, or rctro-esophageal. When a number of persons in the same region areattacked with goiter the condition is frequently referred to as epidemic the condition is common in a certain district it is called endemic a person
. Modern surgery, general and operative. asionally occur. Further, a goiter may be back of the sternum, that is,substernal or retrosternal. A very movable goiter, which is now above and nowbelow the sternal notch, is called a wandering or diver goiter. A goiter withinthe thorax is called intrathoracic; and such a goiter may be retrosternal, retro-tracheal, or rctro-esophageal. When a number of persons in the same region areattacked with goiter the condition is frequently referred to as epidemic the condition is common in a certain district it is called endemic a person living in a district in which the disease is rare develops goiter,we speak of the condition as sporadic goiter. It has long been known thataccessory or aberrant thyroids exist. The term **aberrant is better than ac-cessory because in some reported cases the thyroid proper has been absent (, in Surg., Gynec, and Obstet., Oct., 1906). Aberrant thyroidsare masses of tissue composed of structure identical with the thyroid Fig. SS4.—Parench}-matous goiter. Fig. 8S5.—Adenomatous goiter. and distinct and separate from the thyroid gland proper. Median aberrantthyroids are found about the hyoid bone and are formed from remnants of thethyroglossal duct. Lateral aberrant thyroids are found and develop from theremains of the lateral anlages of the thyroid (Ibid.). Aberrant thyroids varyin number: there may be none, one, several, or chains of them. An aberrantthyroid may enlarge with the thyroid, may not enlarge even though the thyroiddoes, or may enlarge when the thyroid proper remains normal. I recently sawa median tumor of the base of a mans tongue which on removal, proved to becomposed of thyroid tissue (lingual goiter). Nearly 100 cases are on record, 90per cent, of them in women. In a number of cases myxedema has followedremoval. When cachexia strumipriva does not develop after complete thyroid-ectomy, the patient has been saved by enlargement and functionation
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