INVOLUTIONAL OR REGRESSIVE CHANGES IN THE THYROID GLAND IN CASES OF EXOPHTHALMIC GOITER: AND THEIR RELATION TO THE ORIGIN OF CERTAIN OF THE SO-CALLED ADENOMAS

INTRODUCTION  Nearly a century has now passed since Robert Graves¹ in 1835 first described the clinical syndrome that at present bears his name and characterized this disease as being due to an hypertrophy of the thyroid gland. The first descriptions of the histologic changes occurring in hypertrophy and hyperplasia of the thyroid gland were made in 1886 by Horsley² and in 1896 by Halsted,³ when they reported the compensatory changes occurring after partial thyroidectomy in animals. Greenfield⁴ in 1893 expressed the belief that certain specific changes occurred in the structure of the thyroid gland in exophthalmic goiter and this has been confirmed by many observers, most notable among whom are Lewis,⁵ MacCallum,⁶ Hanseman,⁷ Lubarsch,⁸ Ewing,⁹ Wilson,¹⁰ MacCarty¹¹ and Kocher.¹²The studies made by these observers have been so detailed and complete that little new has been added to