Joll's Diseases of the Thyroid Gland

Chapter I.—Histo-Physiology of the Thyroid Gland The Thyroid Follicle The Endogenous Iodine Cycle Iodide Uptake Hormone Synthesis The Thyroglobulin Compartment The Definitive Secretion of the Follicle Radio-Iodine Uptake and Clearance as Indicators of Thyroid Function Regulation of Thyroid Secretion Pituitary Thyrotropic Hormone in Health and Disease Thyrotropic Hormone in the Blood Iodine Absorption and Excretion The Role of the Liver in the Endogenous Iodine Cycle The modus operandi of the Thyroid Hormone Dosage and Activity of Thyroxine Thyroid Hormone and Tissue OxidationsII.—Structure and Development of the Thyroid Gland Comparative anatomy Embryology Anatomy Micro-anatomyIII.—Classification of Thyroid DiseasesIV.—Simple Goitre Definition Classification Mechanism of Simple Goitre Formation Iodine deficiency Geographical Distribution Relationship of Adolescent to Established Goitre Sporadic or Residual Goitre Diet Aetiological Role of infections Geology Mineralogy and Soil in Relation to Goitre Heredity Social Status and Occupation.V.—Simple Goitre—Pathology Parenchymatous Goitre Colloid Goitre Nodular Goitre Radioiodine Studies of Thyroid Nodules Single Adenomata Thyroid Cysts Degeneration Cysts Retention Cysts Chemistry of Simple Goitre Pathological Anatomy.VI.—Simple Goitre—Clinical Features Clinical Features Pressure Signs Cough Stridor Alterations in Voice Pressure on Oesophagus Dysphagia Pressure on Arteries, Veins, Nerves Recurrent Laryngeal Paralysis: Sympathetic, Vagus, Cervical or Brachial Plexus Methods of Examination of Thyroid Enlargements Size Examination of other Structures in the Neck Consistency Mobility of the Tumour Movements on Deglutition Skiagraphy in Simple Goitre Functional Tests in simple Goitre.VII.—Special Types of Simple Goitre—Treatment of Simple Goitre General Phenomena associated with Simple Endemic Goitre Simple Goitre associated with Acute Dyspnoea Simple Goitre and Pregnancy Intrathoracic Goitre Intrathoracic Goitre proper Mediastinal Goitre Goitre Plongeant Substernal Goitre Mechanism of Production of Intrathoracic Goitres Pathological Anatomy Incidence Age and Sex Signs and Symptoms Dyspnoea Diagnosis of Intrathoracic Goitre Prognosis and Treatment Prophylaxis of Simple Goitre Iodine as a Prophylactic Methods of Prophylaxis Dangers of Iodine Prophylaxis and Treatment Thyroid Preparations and the Treatment of Simple Goitre Radiation Treatment of Simple Goitre The Surgical Treatment of Simple Goitre Single Adenomata or cysts Prophylactic Operations on Thyroid Adenomata Cosmetic Indication for Operation on Simple GoitreVIII.—The Hypothyroid States Classification of Cretinism Aetiology Pathology of Thyroid Gland Systemic Effects Skeletal Changes in Cretinism Diagnosis Clinical Course and Prognosis Myxoedema Definition and Types Spontaneous Myxoedema Pathology of the Thyroid Gland Systemic Effects of Myxoedema The Tissue Changes Contrast with Thyrotoxicosis Cutaneous Lesions in Myxoedema — Postoperative Myxoedema Pituitary Myxoedema Latent Hypothyroidism Mixed Endocrinopathies, including Myxoedema Diagnosis, Prognosis and Treatment of MyxoedemaIX.—Graves" Disease — Types — Nature — Nomenclature —HistoryX.—Thyrotoxicosis: Nature and Clinical Factors in Its Aetiology and Pathogenesis Nature of Thyrotoxicosis Geographical Distribution Antecedent Goitre Climatic Factors Urban and Rural Influences Prevalence Sex Incidence Age of Onset Heredity Constitutional Predisposition The Autonomie Nervous System and Toxic Goitre The Sympathetico Adrenal System and Thyrotoxicosis Has Thyrotoxicosis a Thyroid or Extra-Thyroid Origin? What has Thiouracil taught us concerning Pathogenesis? Significance of the Thyroid Stump Dietary Influences Neurogenic Psychic Trauma Infectious Disease and ToxaemiaXI.—The Thyroid Gland in Thyrotoxicosis Toxic Diffuse Goitre: Pathological Anatomy Histology Effect of Therapeutic Agents Thiouracil Toxic Nodular Goitre Lymphoid Hyperplasia Clinical Features.XII.—The Cardiovascular System in Thyrotoxicosis Disordered Physiology of the Circulation Pathological Anatomy and Histology of the Heart Does Heart Failure occur if Thyrotoxicosis is uncomplicated by organic disease of the heart? Clinical Features of the Heart and Vascular System Thyrotoxicosis plus Hypertensive Heart Disease Thyrotoxicosis and Arteriosclerosis Rheumatic Heart Disease and Thyrotoxicosis Pulmonary Heart Disease and Thyrotoxicosis Syphilitic Heart Disease and Thyrotoxicosis Arrhythmias in Thyrotoxicosis The Electrocardiogram Radiological Aspects of the Heart.XIII.—The Nervous System in Thyrotoxicosis Nervous Manifestations produced by Thyrotoxicosis Hyperexcitability Changes in Personality Cycloid and Schizoid Tendencies Toxic Confusional States — Neurosis and Psychoneurosis associated with Thyrotoxicosis Organic Reaction-types of Mental Disorder associated with Thyrotoxicosis.XIV.—Other Systems in Thyrotoxicosis Skeletal Muscles in Graves" Disease Skeletal Changes in Thyrotoxicosis Ovarian, Adrenal, and Pancreatic Changes The Thymus and Lymph Glands Pathology of the Liver Changes in the Blood Picture Cutaneous Manifestations of ThyrotoxicosisXV.—The Ocular Manifestations of Graves" Disease Historical Sketch Definitions and Anatomy of Exophthalmos Bulging of the Lids Diagnosis and Varieties of Exophthalmos Retraction of the Lids — Ophthalmoplegia Morbid Anatomy and Histology of the Retro Bulbar Tissues Ophthalmic forms Natural History of the Ocular Changes Effect of Thyroidectomy on the Ocular Changes Pathogenesis of the Eye Changes Treatment of Malignant Exophthalmos.XVI.—Biochemical Abnormalities in Thyroid Disease Introduction Basal Metabolism Method of Estimation Sources of Error Normal Limits Values in Disease Serum Cholesterol Estimations Blood Iodine Estimations Liver Function Tests Miscellaneous Metabolic Changes.XVII.—The Treatment of Thyrotoxicosis Prophylaxis Control of Hyperthyroidism Principles of Treatment Management of Patients Effect of Iodine on the Toxic Gland after Anti-thyroid Therapy Definitive Anti-thyroid Therapy Drug Reactions Clinical Manifestations of Anti-thyroid-Drug Sensitivity —Pathology of Drug Reactions Treatment of Drug Reactions — Treatment of Special Clinical Groups Radio-Iodine Therapy.XVIII.—Developmental Anomalies of the Thyroid Gland Classification of Congenital Anomalies.XIX.—Acute Inflammations of the Thyroid Gland Suppurative and Non-Suppurative Varieties Strumitis Thyroiditis Incidence Causes Routes of Entry of Micro-Organisms Bacteriology Morbid Anatomy Microscopical appearances Clinical Features Special Types Differential Diagnosis Prognosis and Sequelae Treatment Illustrative Cases.XX.—Granulomatous Diseases of the Thyroid GlandXXI.—Struma Lymphomatosa (Hashimoto"s Disease), Riedel"s Struma and Subacute (Pseudo-Tuberculous or Giant-Cell) Thyroiditis Historical Summary Differentiation from Riedel"s Struma Incidence Age Incidence Sex Incidence Geographical Distribution Pathological Anatomy Comparison with Riedel"s and Allied Disorders Morbid Histology Pathogenesis and Aetiology Clinical Features of Hashimoto"s Struma Diagnosis Treatment Prognosis.XXII.—Malignant Disease of the Thyroid Gland Incidence Age Pathology Iodine Content of Malignant Goitre Classification of Malignant Neoplasms Papillary Carcinoma Adenocarcinoma Highly Malignant Forms Lateral Aberrant Thyroid Rare Forms Metastatic Tumours Metastases from the Thyroid Diagnosis of Malignant Tumours Differential Diagnosis Prognosis Treatment Benign NeoplasmsXXIII.—Hydatid (Echinococcus) Disease of the Thyroid Gland Pathology Clinical Features Prognosis Treatment.XXIV.—Amyloid GoitreXXV.—Anaesthesia for Goitre Operations Introduction Examination of Patient : Operative Risk Premedication Stealing the Thyroid Local Anaesthesia Infiltration Cervical Plexus Block General Anaesthesia Intubation.XXVI.—The Operation of Thyroidectomy for Thyrotoxicosis Principles and Practice of Thyroidectomy Revisor"s Preliminary Note Certain Points in the Technique of Resection for Recurrent Thyrotoxicosis Position of Surgeon and Assistants Instruments Incision Division of Infrahyoid Muscles Separation of Muscles Ligation of Middle Thyroid Veins Dislocation of Lateral Lobe Ligation of Inferior Thyroid Artery of Inferior Veins Continuation on right side Resection of Gland Tissue Completion of Haemostasis Thermo-electric Methods Wedge-resection Testing Haemostasis Closure of Wound D.ainage —Dressings.XXVII.—Technique of Operations for Non-Toxic Goitre Operations for Single Adenomata and Cysts Steps of the Operation of Resection-Enucleation Operations for Colloid Goitre Operations for Intrathoracic Goitre Operations for Malignant Goitre Operations for Chronic Thyroiditis: Tuberculous Syphilitic Riedel"s Disease Lymphadenoid Goitre Operation for Acute Thyroiditis.XXVIII.—Dangers and Difficulties During Thyroidectomy: Usual Post-Operative Course and Management Errors on the Operation-table Haemorrhage Injuries to Trachea and Oesophagus Tracheal Collapse Injuries to Pleura Air Embolism Wounds of Cervical Sympathetic, Vagus and Hypoglossal Nerves, and Thoracic Duct Post-operative Course and Progress Post-Operative Treatment.XXIX.—Post-Operative Complications and Their Treatment Prophylaxis Acute Crises Haemorrhage Cyanosis Embolism Respiratory Complications Wound Infections Tetany: Treatment Cachexia Strumipriva Symptoms Treatment: Laryngeal Paralyses Treatment: Injuries to Cervical Sympathetic Trunk—Imperfections of Scar — Swelling of FaceIndex