Congenital goitre / by Alexander R. Simpson.

  • Simpson A. R. (Alexander Russell), 1835-1916.
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: Congenital goitre / by Alexander R. Simpson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    which is removed when a cord is tied before being cut. The thyroid arteries and veins were gorged with blood. On incision of the tumour there flowed out a quantity of blood; it resembled, up to a certain point, a piece of hepatised lung, or rather the pathological condition which Laennec describes in speaking of pulmonary apoplexy. A section of this gland was submitted to microscopic examination before being macerated, but it was impossible to trace the glandular elements. After a maceration of two days, the blood had almost disappeared, and all the con- stituent parts of the gland could then be traced. A certain quantity of blood, however, remained in the vascular canals. Although occurring only with comparative rarity as a separate affection, we not infrequently see this vascular variety—at least in its stage of excessive congestion, complicating the more common form of congenital goitre. Such, I doubt not, was the case with the infant whose history I have narrated; and such was shown by post-mortem examination to have occurred in a fatal case related by Dr. Maurer* who found both lobes enlarged and of a brown red colour, and the veins passing downirom the gland greatly swollen, some of the vessels being distended with dark blood to the thickness of a goose quill. 3. Struma fibrosa—characterized by a hard and commonly uniform tumour, ordinarily occupies only one lobe of the thyroid body, and has not, so far as I am aware, been met with as a congenital affection. II.—ETIOLOGY. Without entering on the wide and much-debated question, as to the cause or causes of the prevalence of goitre in certain districts, I remark, first, that, in the writings of those who are treating of the endemic relations of the disease, there is occasional reference to its occurrence in the congenital form. Fodere-f* was furnished with several examples by the clergymen of the different Swiss valleys which he visited, and had himself an opportunity of seeing three. In Strasburg, where the disease is endemic, Professor Tourdes % found at one time that, in the Maternite' and the Creches, out of thirty-one infants there were three with congenital hypertrophy of the thyroid gland. In a report§ on the health of the popul- * Journal fiir KinderJcrankheiten. Band xxii., S. 357. 1854. t Traite du Goitre et du Cretinismc, 1808, p. 68. X Gazette de Strasbourg, 7. 1854. Schmidt's Jahrbiicher 85, 1855 S. 225. ' ' § Schmidt's Jahrbiicher, 94, 1857, S. 368.