The goitrous conditions of the thyroid gland

In presenting this study of the Pathology of Goitre I would like to make it clear that the work arose as a corollary to a more general inquiry into the problems of *Protein* disturbances both dietetic and inflammatory. The first observations were made, post mortem, on children that had died from unexplained causes after a tentative clinical diagnosis of dietetic disturbance varying from anaphylaxis to diarrhoea and vomiting. It became apparent that children could be placed in one of three groups: — normal, lymphoid, or alymphoid, if attention were directed to the thymus, spleen, pyloric mucosa, appendix and tonsils (faucial and pharyngeal). Associated with this there appeared in certain sites in the peritoneum (pyloric and caeco-appendicular) changes in the fat tissue which seemed to vary in its lymphoid character with the thymus - perhaps like the thymus the range of its meta-trophy is between lymphocytes and fat - in an endothelial organ. From this attention was soon called to the thyroid gland, Graves' disease, and to the histopathology of appendicitis and gastric ulcer by reason of the constant lymphocytic reaction presented in these conditions