GOITRE (Fr., from Lat. gutter, throat). An enlargement of the thyroid gland (q.v.) occupy ing the front of the neck, and sometimes of such a size as to project downward over the breast and even admit of being thrown over the shoulder. Goitre is, for the most part, an endemic or local disease, being found in the mountainous regions of the Alps, Andes, and Himalayas, in the Pennine Range, and in Derbyshire, England (whence Der byshire neck), in the Rhone valley, in the Indian Punjab, and in North Italy, especially, it is said, where lime prevails largely as a geological forma tion. The proofs of goitre being connected with a calcareous impregnation of the drinking-water are strong. Women are oftener affected with goitre than men. An explanation offered for this fact is to the effect that they drink more water than men. Goitre is met with endemically to a slight extent in various parts of Scotland, but on a very small scale indeed as compared with Switzer land, in which it is a very important deformity, especially when connected with cretinism (q.v.). Sporadic goitre may occur in any country. The pathological changes which underlie the enlarge ment of the thyroid in goitre are not always the same in all cases. In some cases the enlarge ment is general with the formation of many new follicles, which contain a gelatinous material known as `colloid.' In other cases there is lit
tle new gland formation, the increase in size being due to dilatation of the blood-vessels. In still other cases the gland is the seat of cysts of various sizes. In the form of goitre known as exophthalmic goitre (see BASEDOW'S DISEASE), which is marked by protrusion of the eyes (ex ophthalmos) and functional disturbance of the heart action, there is increase in the size of the thyroid, which Greenfield describes as a condition of active glandular proliferation. From the symptoms of this disease taken in connection with the known effect of thyroid extract upon the system, it seems probable that the change in the gland is the pathological basis of the disease. The usual treatment of goitre consists in the administration of very minute doses of iodine for a long time internally, locally by inunction, or locally by cataphoresis. (See ELECTRICITY, MEDI CAL USES OF.) In a few rare cases, the admin istration of thyroid gland has cured. In others, the administration of thpnus gland has cured.
GoKINGK, gnink, LEOPOLD FRIEDRICH GUN THER VON. See GoCKINGK.