Page:On the pathology of exophthalmic goître.djvu/4

 The wound healed by first intention, and the only changes noticed in the animal afterwards were slight hebetude, increased stupidity, and harshness of the voice. In March, 1895, fourteen months after the operation he developed general tuberculosis and was therefore killed. A piece of thyroid gland, weighing 0.42 gramme, was found on the right side, evidently a piece of the original gland which had hypertrophied. The pituitary gland weighed 0.05 gramme. Fig. 3 represents a portion of this piece of hypertrophied thyroid gland. The most important changes are: 1. The formation of new alveoli, some of which are filled by the epithelial cells. 2. Folding of the wall of the alveoli in some places so that the internal surface of the epithelium is increased in extent. 3. A change of the epithelial cells from a cubical into a columnar form. Compared with the normal thyroid gland of the monkey we have here clearly the appearances presented by a gland which



is working at high pressure somewhat in the same manner that the mammary gland shows signs of unusual activity during lactation.

Fig. 4 shows the changes which were present in one lobe of the gland which was removed from one of my patients by Mr. F. Page of Newcastle. There is evidently a great increase in the amount of secretory tissue as compared with that in the normal gland (Fig. 1), for the number of alveoli is in- creased, and in some places the alveoli are filled with epithelial cells and show no central space filled with colloid, so that in any given area of the gland there are many more secreting cells than in health. The epithelial cells themselves are also changed, for instead of being cubical they are increased in size and columnar in type. There is less colloid substance to be seen than in health; this is probably due to increased rate of removal from the gland.