. The thyroid gland in health and disease. FiG. 35.—Case of endemic goitre, containing small nodule in isthmus, beforetreatment by thymol. Circumference of neck, 40|- cm. ever, a measure which is not practicable in the majority of such circumstances, treatment should be directed to theremoval of the exciting cause of the disease, and of the factorswhich favour its action. In dealing with the exciting agent or agents of goitre it isnecessary (1) to prevent their entry into the body, and (2) to TREATMENT 107 destroy or diminish the number of those which already existtherein. We must,
. The thyroid gland in health and disease. FiG. 35.—Case of endemic goitre, containing small nodule in isthmus, beforetreatment by thymol. Circumference of neck, 40|- cm. ever, a measure which is not practicable in the majority of such circumstances, treatment should be directed to theremoval of the exciting cause of the disease, and of the factorswhich favour its action. In dealing with the exciting agent or agents of goitre it isnecessary (1) to prevent their entry into the body, and (2) to TREATMENT 107 destroy or diminish the number of those which already existtherein. We must, therefore, correct all unhygienic conditionsof life, advise the use of boiled water or of water which has beensterilized, and instruct the patient to avoid the contaminationof the food by soil-infected hands. Of remedies which may be. Fig. 36.—The same case after treatment by thymol. Circumference of neck,37 cm. The swelling has completely disappeared, except for the nodule in theisthmus. employed to destroy or to reduce the numbers of goitrigenousorganisms or their toxins in the alimentary tract, the most im-portant are the antiseptics—iodine, thymol, salol, /3-naphthol,benzo-naphthol, quinine, hydrofluoric acid, the bacillus bulgaricus—and vaccines. Iodine is the most potent of all known remedies in the 108 ENDEMIC GOITRE treatment of parenchymatous goitre. It possesses the specificproperty of causing the thyroid to revert to the colloid state ; itsaction is also anti-toxic and anti-septic. It is best given in theform of the tincture, either alone or combined with iodide ofpotassium, or as Syrup ferri iodidi. The drug must be ad-ministered in sufficiently large doses to be efficacious, but thesmallest dose which produces the desired effect is the dose toemploy. Five minims of the tincture, combined with fiv
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