. Modern surgery, general and operative. y die within sixmonths and few survive over eighteen months. Radical operation is properonly before the growth breaks through the capsule, although at any stage it maybe necessary to operate in order to prevent suffocation. A goiter^ is an enlargement of the thyroid gland not due to a malignanttumor or to inflammation. Hippocrates makes no mention of goiter. Juve-nal and Pliny refer to it. Juvenal speaks of its being common among Alpinemountaineers and Pliny states that certain wells seem to disseminate thedisease. The enlargement may affect a small por
. Modern surgery, general and operative. y die within sixmonths and few survive over eighteen months. Radical operation is properonly before the growth breaks through the capsule, although at any stage it maybe necessary to operate in order to prevent suffocation. A goiter^ is an enlargement of the thyroid gland not due to a malignanttumor or to inflammation. Hippocrates makes no mention of goiter. Juve-nal and Pliny refer to it. Juvenal speaks of its being common among Alpinemountaineers and Pliny states that certain wells seem to disseminate thedisease. The enlargement may affect a small portion of the gland, one lobe,both lobes, or both lobes and the isthmus, and it may occur either sporadicallyor endemically. It is fcft- more common in women than in men. It is very com-mon in adolescent girls. It may exist in children. Adenomata may even becongenital. 1 For a study of the Pathological Anatomy of Goiter see W. C. MacCarty, in NewYork State Jour, of Med., Oct., 1912. This study is founded on 2500 cases from the Fig. 882.—Sarcoma of thyroid gland. 1372 Diseases and Injuries of the Thyroid Gland There are a number of forms of ordinary goiter. The most common iswhat is called simple or parenchymatous goiter (Fig. 884). In this condition allportions of the gland enlarge, and the goiter is consequently bilateral. It doesnot appear first in one lobe and at a considerably later period in the other,but each lobe is enlarged equally or nearly equally. Parenchymatous goiteris often spoken of as simple goiter, and is sometimes, though not with entireaccuracy, designated hypertrophy of the thyroid gland. The common goiter of adolescence is an edematous condition of the glanddue to watery colloid (C. H. Mayo, Illinois Med. Jour., Feb. 1913). Adenomatons goiter (Fig. 885) is a condition due to the growth of encapsuledadenomata in the thyroid gland. There may be a single adenoma, but fre-quently there are multiple growths. One or both lobes may be involved. Thegoi
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