ACCESSORY THYROID BODIES.—Lying in the tissues between the hyoid bone and the aortic arch are occasionally to be found certain small bodies which at first sight may be mistaken for lymph glands, but upon microscopical examina tion are seen to be of the nature of thy roid tissue. Gruber distinguishes be tween them the superior, inferior, and posterior glands.
These accessory glands occasionally become the seat of adenomatous or even carcinomatous enlargement, and may cause great difficulty in diagnosis. The posterior group, more especially lying behind the oesophagus or between the trachea and the oesophagus, must be kept in mind from the grave disturbances which may be caused, either in degluti tion or in respiration, through their over growth.
Case of migratory goitre caused occa sional attacks of cyanosis and dyspmea. A small, movable tumor was seen on the right side of the neck. The tumor mi grated at times toward the mediastinum, compressing the trachea and right in nominate vein. Removal of a few adcnomatous nodules and fixation of right half of thyroid resulted in a cure. M. A. WUHier (Revue Gen. de Clin. et de Therap., Sept. 29, '89).
Case of iutralaryngeal thyroid tumor. There are only five or six such cases in literature. The patient complained of dyspnma. On laryngoscopical ex amination a tumor could be seen under the right vocal cord. Three months
later abscesses appeared in the left lobe of the thyroid, the patient finally dying of general septicmmia. On post mortem examination the tumor was found to consist of thyroid tissue and to be connected with that gland. R. Pal tauf (Wiener med. Woch., May 16, '91).
Case of accessory thyroid in the base of the tongue, removed for great dys phagia. Recovery. Wolff (Gaz. Med. de Paris, Oct. 10, '91).
Symptoms. — ACUTE GOITRE. — This form differs from the main mass of cases in that, within the course of a few days or even a few hours, tilt thyroid may so swell as to produce peculiarly severe symptoms, more especially of impeded respiration, prolonged inspiration, and paroxysmal dyspnwa; it may be followed by evidences of bronchial catarrh. Koe nig notes that during the menstrual period, during which, as already stated, some hypercemic enlargement of the thy roid may be noted, it is not uncommon for there to be a peculiarly raw cough and distinct modification of the voice directly due to this enlargement. In the more severe cases the respiratory dis turbance may lead to death from as phyxia. Where death does not occur, the gland may gradually lessen in size and the goitre disappear.