Edmund Owen

“ A throbbing is felt throughout the body, and many of the larger blood-vessels are, like the heart, seen to pulsate strongly. The enlargement of the thyroid is gradual, and rarely increases to any great size, thus differing from the commoner form of goitre. The enlarged gland is of soft consistence, and communicates a thrill to the touch from its dilated and pulsating blood-vessels. Accompanying the goitre a remarkable change is observed in the eyes, which attract attention by their prominence, and by the startled expression thus given to the countenance. ”

“ It occasionally happens that in undoubted cases of the disease one or other of the three above-named phenomena is absent, generally either the goitre or the exophthalmos. The palpitation of the heart is the most constant symptom. Sleeplessness, irritability, disorders of digestion, diarrhoea and uterine derangements, are frequent accompaniments. It is a serious disease and, if unchecked, may end fatally. ”

“ Occasionally the enlargement is uniform, but more commonly one of the lobes, generally the right, is the larger. In rare instances the disease is limited to the isthmus which connects the two lobes of the gland. The growth is unattended with pain, and is not inconsistent with good health.
Goitre is a marked example of an endemic disease. ”