British medical journal . havegoitre and , goitre and Gravess disease,and Gravess disease or myxoedema without goitre. Puzzling as these lUfter-ouces may appear, easily understoodby the aid of the micro-scope, and the work and JIcAitj of the JIayo cliuic hashelped iu explainiugthese seeming anomaliesof thyroid a rule each lobe isV i si b 1 y the isthmusis the prominent is liable to bemisled however, byretrotracheal, retrocla-vicular and retrosternalFig. 3. enlargements ; the latter have been mistaken formediastinal tum
British medical journal . havegoitre and , goitre and Gravess disease,and Gravess disease or myxoedema without goitre. Puzzling as these lUfter-ouces may appear, easily understoodby the aid of the micro-scope, and the work and JIcAitj of the JIayo cliuic hashelped iu explainiugthese seeming anomaliesof thyroid a rule each lobe isV i si b 1 y the isthmusis the prominent is liable to bemisled however, byretrotracheal, retrocla-vicular and retrosternalFig. 3. enlargements ; the latter have been mistaken formediastinal tumours. Osier and Packard have reporteda case of a cystic accessory thyroid filling the entireright pleura. Pressure effects are not always dependentupon size. The firm fibrous goitre may reduce thetracheal lumen to a mere chink. In cases of intractableasthma or paroxysmal dyspnoea it is worth while to bearthis in mind. The sudden development of a thyroid tumour points tahaemorrbaec in the gland substance. A parenchymatous. 820 The BniTisnMkd:cai. Jouhval 1 VACCINE TREATMENT OF GONORRHOEA^ [Nov. 14, 1914 goitre may acquire onormons dimensiong wliicli mayorocluco marked congeatioa of the veins of the face, chestind upper extremities, and whieli may lead to actualthrombosis. If a goitre ia producing respiratory em-barrassment, the sooner operation is undertaken thebetter. Oravess Disease.—The cardinal signs of exoiihthalmos,tachycardia, and tremor make the diagnosis of this condi-tion easy. The ocular signs are well known. Theetiology of the disease is obscure. The main issues are[a) that it is a neurosis, (6) that it is the result of pervertedsecretion or hypersecretion, (c) that it is due to have described haemorrhages in the fourthventricle. If these haemorrhages were a constant featurewe may be justified in assuming that the glycosuria ofGraves resulted from a medullary lesion analagous toClaude Bernards puncture of the fourth the notewor
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Keywords: ., bookcentury1800, bookdecade1850, booksubjectmedicine, bookyear185
