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June 4, 1938

THE THERAPY OF THE COOK COUNTY HOSPITAL

JAMA. 1938;110(23):1916-1920. doi:10.1001/jama.1938.62790230004012

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Abstract

THE THERAPY OF GOITER AND OF HYPERTHYROIDISM  In Collaboration with Lindon Seed, M.D.The diagnostic characteristics of thyroid enlargement are that it follows the movements of deglutition and coughing. These are absent when the size of the mass is excessive or when there are adhesions.It is important for therapy to distinguish between true goiter and (a) thyroid congestion, (b) inflammation or (c) a malignant condition.

  • Thyroid congestion causes a moderate periodic, symmetric, smooth, painless enlargement of the gland during periods of stress, such as menstruation or pregnancy. It needs no treatment.

  • Thyroid inflammation and acute suppurative thyroiditis are exceedingly uncommon. They set in suddenly after injury or during an infectious disease and have associated the signs of inflammation. The gland is hard and tender and there may be chills and fever, dyspnea, dysphagia and radiating pains. Abscesses may develop, which, when well localized, demand surgical drainage. Chronic

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