Diseases of the thyroid gland and their surgical treatment

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P. Blakiston's son, 1901 - Goitre - 383 pages
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Page 71 - That there exists some definite relation between endemic goitre and some poison in the soil upon which it is found is tolerably clear, and there can be no doubt that in the vast majority of cases drinking water is the vehicle by means of which that poison obtains access to the body.
Page 238 - ... applied for three or four weeks — sometimes longer. When suppuration is well set up, the plug may be removed, the canula, however, being allowed to remain until the secretions become limited in amount, and thin in consistence. When the cyst is very large it is best to try to reduce the quantity of the fluid before injecting. This can often be done by drawing off" a small amount, say two or three drachms, at intervals of a day or two, on several occasions.
Page 195 - ... patient's discharge, to send the physician a suggestive outline of after-cure. The patients must be protected as far as possible from unnecessary physical or nervous fatigue, and to this Ochsner adds the importance of rather rigid dietary regulation on which he lays great emphasis." — Frazier. "Reviewing the whole subject of the operative treatment of exophthalmic goitre, it seems to me that it may reasonably be doubted whether surgical treatment is not on the whole worse than useless.
Page 255 - That the relief afforded may be permanent, but that frequently the " goitre reappears when the wound has healed, and the secretion is
Page 192 - ... at frequent intervals. For five days subsequent to the operation there were symptoms of sepsis, the highest temperature being 103.7, and the pulse ranging from 100 to 120. On the beginning of the sixth day the temperature and pulse fell, and the patient went on to an uninterrupted convalescence. The wound healed by first intention, and the patient left the hospital well at the end of three weeks. It was by no means easy to make a differential diagnosis between a right-sided ovarian cyst with...
Page 238 - One injection is generally sufficient, but if the first injection fluid be too quickly removed, the process may have to be repeated three or four times at intervals of two or three days.
Page 8 - Blood-vessels.—The thyroid gland has a relatively large blood supply. The chief arteries are the superior and inferior thyroid, the former derived from the external carotid, the latter from the thyroid axis, a branch of the first part of the subclavian. The superior thyroid artery meets the gland at the tip of its upper horn. Here the artery frequently gives offa large branch which passes down to the back of the gland.
Page 238 - ... small amount, say two or three drachms, at intervals of a day or two, on several occasions. No attempt must, however, be made to empty the sac entirely, for if this is done, haemorrhage takes place from the lining membrane of the cyst into its cavity, which soon becomes full again. The duration of treatment is from three weeks to four months, according to the size of the cyst, the usual time being from six to eight weeks.
Page 237 - The cyst is first punctured and emptied with a trocar at its most dependent part, a drachm or two (according to the size of the cyst) of the solution of perchloride of iron is then injected, the canula with its plug and the iron solution being left in the cyst.
Page 244 - Rydygier). This appears to be the best method, at any rate for cases in which the gland is much enlarged. The incision is made at the posterior border of the sterno-mastoid. It begins at the clavicle or a little above it and is carried upwards to the point at which the external jugular vein crosses the posterior border of the sterno-mastoid, usually on a level with the lower border of the thyreoid cartilage. The sterno-mastoid muscle and carotid sheath are drawn inwards and the artery found as above....

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