Definition

Enlargement of the thyroid gland. It may occur sporadically or in epidemic form.

There are three varieties of true hypertrophy of the thyroid gland. The first is a follicular enlargement: newformed tissue develops--gelatinous material accumulates in the follicles. The second variety is vascular. In this variety the enlargement is due entirely to enlargement of the blood vessels. This is the variety that is so formidable when surgeons undertake to extirpate it. Bleeding is tremendous, and I think the majority of surgeons go no farther in such cases than to ligate the artery; which treatment may be somewhat beneficial, but collateral circulation wilt be established and the gland will continue to enlarge. We are having a great many operations of this character, and they are of no special benefit. Why should they be? No cause is even thought of, to say nothing about any attempt being made to overcome the cause.

The third variety is cystic goiter. This is characterized by a growth resembling cystic tumors. Occasionally this variety will grow to enormous size--as large as a human head. We hear occasionally of epidemics of goiter in different parts of the country. No doubt suggestion has something to do with this disease as well as with others, but there must be something atmospheric as well as dietary. There are certain sections of the countries of Great Britain, France, and Italy where the disease prevails. When the truth is known, it will be found that the foods in such communities are deficient in certain elements, or the style of eating of the people is such as to deprive the system of some of the vital elements necessary to keep a well-balanced state of health. Families and communities exchange ideas, patterning after each other in their style of eating as well as of dressing, and it is not strange that diseases of a certain character should develop in certain communities.

Symptoms

An enlargement at the base of the neck--easily discovered where the enlargement is of any size--may be looked upon as a goiter. Just what kind of goiter is presenting must be left to the diagnostic skill of the physician, and just what can be done in any individual case must depend entirely upon the causation. It is my opinion that the majority of cases of goiter of any character have a primary cause of toxin poisoning--or a state of infection due to intestinal absorption of putrefaction.

Treatment

Correct the habits or the life. See that the patient is fed properly. If there is a uterine affection, it must be corrected. As a rule, there is a sensitiveness of the mammary glands, and in too many cases the glands are removed because of a suspicion that the disease is cancer or will develop into cancer. The truth is that the uterine derangement, the mammary-gland enlargement, and the goiter all are caused by the same basic lesion. Where there is a great deal of fibroid development the disease is hard to overcome; but this tissue can be caused to absorb, if the patient will be persistent in living correctly.