INFLAMMATIONS OF THE THYROID Acute inflammation of the thyroid as a primary affection is exceed ingly rare (Demme, Stamm). In nearly all cases it is a secondary involve ment in the course of infectious diseases. As a primary affection it occurs after traumata, after use of brute force, and after birth lesions without any assignable cause. The symptoms are swelling of the thyroid, sus ceptibility to pressure, and restricted motility of the neck. Application of cold usually leads to rapid abatement, of the swelling, but in ulcerative cases surgical interference is required.
Secondary thyroiditis, however, occurs somewhat more frequently in the course of infectious diseases. It is especially observed in the course of typhoid, scarlet fever, diphtheria, nieasles, articular rheuma tism, malaria, and mumps. There arc pain and swelling in the thyroid region and, unless resolution occurs, there will be abscess formation. The presence of typhoid bacilli, streptococci, staphylococci, and pneumo cocci was demonstrated in pure culture. The manifestations usually
abate within a few days, although in rare eases there is hypermmia of the skin with fever and fluctuation with abscess formation. Atrophy of the gland and its sequehe occur still less frequently.
The prognosis is good even in ulceration observed after typhoid.
The treatment consists in the application of cold by bandaging the neck with an ice collar; or, when there is ulceration, by warm bandages, followed by incision.
Chronic inflammation of the thyroid is exceedingly rare. It some times leads to atrophy- of t,he organ with symptoms of athyreosis, which will be discussed later, accompanied by increasing functional insuffi ciency of the thyroid (myxeedema, arrest of physical and mental develop ment).
As neither tuberculosis nor syphilis ever causes isolated affection of the thyroid. they do not require any special discussion.