The present status of the surgery of systematic goitre : illustrative cases / William Seaman Bainbridge, A.M., Sc.D., M.D.

  • William Seaman Bainbridge
Date:
[1914?]
Catalogue details

Licence: In copyright

Credit: The present status of the surgery of systematic goitre : illustrative cases / William Seaman Bainbridge, A.M., Sc.D., M.D. Source: Wellcome Collection.

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    manent cures in the grave forms of the disease are very rare. On the other hand, with modern methods of technic and the proper care before Fig. XVII.—Case VII. Three and a half years afterwards. and after operation, the surgical mortality is exceedingly small, while a more or less prompt or progressive improvement, approaching a cure in the majority of cases, is usually obtained by modern goitre operations. ILLUSTRATIVE CASES. The following brief histories, with pictures, selected from a large number of cases operated upon by different methods, according to require¬ ments, illustrate some types of operative technic and results. Elsewhere I have dealt with other phases of the subject. (See bibliography). Case T.—G. female, aged 55. Symptoms.—Gradually growing worse for some years. Nervous, rapid heart, tremor, general weak¬ ness ; enlarged and throbbing neck. At times so depressed as to appear to be a typical case of melancholia. Operation, July, 1912. Partial thyroidectomy, right half, and a small portion of left upper pole removed, under local anesthesia. Recovery uneventful. Grad¬ ual gain in nervous and physical strength. All melancholia disappeared. Perfectly well February 14, 1914. Case II.—W., female, aged 68. Referred by Dr. James A. Babbitt, of Philadelphia. Symptoms.—Slight goitre at 17, which disappear¬ ed. Three years ago neck gradually grew larger, until there was absolute loss of voice; marked cyanosis at times; frequency of heart action; ner¬ vousness ; some tremor. Operation, August, 1912, under local anesthesia. Removal of right lobe and isthmus. A part of the goitre was markedly calcareous. Recovery un¬ eventful. Within a few days voice began to re¬ turn. Perfectly well, February 14, 1914. Voice normal, no cyanosis. Practically all symptoms re¬ lieved. Case III.—G., male, aged 48. Symptoms.-—Markedly nervous; rapid heart; at times extreme dyspnea, with cyanosis; unable to walk upstairs. Getting steadily worse for some months, unable to work, practically an invalid. Definite hyperthyroidism, but also marked local symptoms from displacement of the trachea one and one-half inches to the right, and softening of sev¬ eral of the tracheal rings by pressure. Operation, February, 1913, under local anesthesia. General anesthesia absolutely contraindicated. Left lobe of thyroid, (Fig. VIII-A), and a growth from the isthmus, (Fig. VIII-B), more than twice the size of the enlarged lobe, removed. Uneventful recovery. Back at work. Well. Case IV.—C., female, aged about 48. Referred by Dr. W. H. Cantle, of Mamaroneck, N. Y. Symptoms.—Nervousness and tremor. Operation, November, 1912, under local anesthesia. Enormous bilateral goitre, with colloid and cystic degeneration. Inflammation involving the skin. Par¬ tial thyroidectomy on each side, including the isth¬ mus, which was markedly degenerated. It was pos¬ sible to leave a small portion of lower pole of each Fig. XVIII.—Case VIII. Before operation. lateral lobe. Recovery uneventful. Perfectly well February 1, 1914. Case V.—B., female, aged 25. Symptoms.—Difficulty in swallowing. Enlarge-
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