TREATMENT. — Besides the antiphlo gistic measures adopted from the start, of which lead-water and laudanum, ice bags, or compresses, etc., are probably the best, the case should be carefully watched lest symptoms of pressure upon important vessels imperil the patient's life. Low tracheotomy (without general is sometimes suddenly neces sary. When an abscess is formed, it should be evacuated as soon as fluctua tion is detected.
Thyroid Fever.—This is a febrile dis order which occurs in cases of partial thyroidectomy. Berard, who observed it in GO per cent. of the latter, and in 70 per cent. of cases of exothyropexy, states that the pulse and respiration are not accelerated in proportion to the rise of temperature. The patient complains of flashes of heat, sweats abundantly, and sometimes has tremor and shows con siderable excitement; there may be patches of cutaneous hyperamlia due to vasodilatation; the tongue remains moist and rosy, the digestive functions are un affected save at the period of decline, when diarrhoea is not uncommon; the heart-sounds are regular and sharp, and nothing abnormal is detected on auscul tation of the lungs. If the wound is un covered at the end of two or three days, the deep parts of the dressing, around the drainage-tubes, are found to be moistened with a clear, odorless serum, and the skin in the neighborhood of the sutures is neither inflamed, hot, nor oedematous. Usually the more abundant
is the serous flow, the higher the tempera ture.
Tumors of the Thyroid.—Roger Will iams, in an analysis of the primary tumors under treatment at four large metropolitan hospitals during a period of from ten to fifteen years, found that of 7294 cancers only 7 originated in the thyroid, and of 1266 sarcomas only 1 started in this situation. A careful search in literature by Tippany and Lanier enabled them to find records of only 16 cases of sarcoma of the thyroid. Of these 4 were doubtful. It appears generally to occur in patients well above forty years of age. Usually the growth is spindle-celled, but may be round celled or mixed. Not one of the cases in the tables of these writers survived the operation, undertaken usually for the re lief of dyspncea, for more than a few days. (Firth, Lancet, Aug. 26, '99.) (See also GOITRE, EXOPIITHALMIC GOITRE, INFANTILE IlvxcEnfillA, and MYXCEDEIVIA.)