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Tuberculosis occurs more frequently in some situations than in others; it is common, for example, in lymph glands, in bones and joints, in the peritoneum, the intestine, the kidney, prostate and testis, and in the skin and subcutaneous cellular tissue; it is seldom met with in the breast or in muscles, and it rarely affects the ovary, the pancreas, the parotid, or the thyreoid.
Portions of the ovary and of the thyreoid have been successfully transplanted into the subcutaneous cellular tissue of the abdominal wall by Tuffier and others.
A form of delirium, sometimes spoken of as #Traumatic Delirium#, may follow on severe injuries or operations in persons of neurotic temperament, or in those whose nervous system is exhausted by overwork. It is met with apart from alcoholic intemperance. This form of delirium seems to be specially prone to ensue on operations on the face, the thyreoid gland, or the genito-urinary organs.
We do not now need to be told that the thyreoid gland plays a very important part in the economy, for we know that its surgical removal gives rise to a special disease known as myxoedema, which, in addition to its physical manifestations, is characterized by impairment of the mental powers.
Secondary tumours derived from the thyreoid gland require special mention, because they are peculiar in that neither the primary growth in the thyreoid nor the secondary growth in the bones is necessarily malignant. They are therefore amenable to operative treatment. Secondary sarcoma, whether derived from a primary growth in the bone or in the soft parts, is much rarer than secondary cancer.
The mode in which cancer causes death depends to a large extent upon its situation. In the gullet, for example, it usually causes death by starvation; in the larynx or thyreoid, by suffocation; in the intestine, by obstruction of the bowels; in the uterus, prostate, and bladder, by hæmorrhage or by implication of the ureters and kidneys.
Some observers even affirmed that they had no function, though the constancy of goître in cretins ought to have shown the fallacy of this allegation in the case of the thyreoid.
Exudation cysts arise from the distension of cavities which are not provided with excretory ducts, such as those in the thyreoid. Implantation cysts are caused by the accidental transference of portions of the epidermis into the underlying connective tissue, as may occur in wounds by needles, awls, forks, or thorns. The implanted epidermis proliferates and forms a small cyst.
The clinical features and treatment of the various forms of papilloma are considered with the individual tissues and organs. #Adenoma.# An adenoma is a tumour constructed on the type of, and growing in connection with, a secreting gland. In the substance of such glands as the mamma, parotid, thyreoid, and prostate, adenomas are met with as encapsulated tumours.
When there is difficulty in applying a ligature securely, for example in a dense tissue like the scalp or periosteum, or in a friable tissue like the thyreoid gland or the mesentery, a stitch should be passed so as to surround the bleeding vessel a short distance from its end, in this way ensuring a better hold and preventing the ligature from slipping.
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