IODINE.

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But, in two or three of the instances before mentioned, I believe thefailure did not arise from any of the circumstances alluded to by Dr. Cop-land, and I am disposed to refer it to some peculiar condition of thetumor, or of the constitution. When we consider that the terms bron-chocele, goitre , and Derbyshire neck, are applied to very different con-ditions of the thyroid gland, and that the causes which produce themare involved in great obscurity, and may, therefore, be, and indeedprobably are, as diversified as the conditions they give rise to, we caneasily imagine that while iodine is serviceable in some, it may be uselessor even injurious in others. Sometimes the bronchocele consists inhypertrophy of the substance of the thyroid gland,—that is, this organ isenlarged, but has a healthy structure. In others, the tumefaction of thegland took place suddenly, and may even disappear as suddenly, fromwhich it has been inferred that the enlargement depends on an accumu-lation of blood in the vessels, and an effusion of serum into its tissue.Coindet mentions a goitre which was developed excessively during thefirst pregnancy of a young female: twelve hours after her accouchementit had entirely disappeared. The same author also relates the circumstanceof a regiment composed of young recruits, who were almost every manattacked with considerable enlargement of the thyroid gland, shortly aftertheir arrival at Geneva, where they all drank water out of the same pump.On their quarters being changed the gland soon regained its natural sizein every instance. A third class of bronclioceles consists in an enlarge-ment of the thyroid gland from the developement of certain fluid or solidsubstances in its interior, and which may be contained in cells, or beinfiltrated through its substance. These accidental productions may beserous, lioney-like, gelatinous, fibrous, cartilaginous, or osseous. Lastly,at times the enlarged gland has acquired a scirrhous condition. Now itis impossible that all these different conditions can be cured with equalfacility by iodine ; those having solid deposits are, of course, most difficultto get rid of.

Kollev, the physician before alluded to, who was himself cured of alarge goitre of ten years’ standing, says, that for iodine to be useful, thebronchocele should not be of too long standing, nor painful to the touch;the swelling confined to the thyroid gland, and not of a schirrous or car-cinomatous nature, nor containing any stony or other analogous concre-tions ; and that the general health be not disordered by any febrile orinflammatory symptoms, or any gastric, hepatic, or intestinal irritation.If the swelling be tender to the touch, and have other marks of inflam-mation, let the usual local antiphlogistic measures precede the employ-ment of iodine. When this agent is employed we may administer it bothexternally and internally. The most effectual method of employingiodine externally is that called endermic, already described; namely, toapply an ioduretted ointment (usually containing iodide of potassium) tothe cutis vera, the epidermis being previously removed by a blister. Butthe epidermic, or iatroleptic method, is more usually followed—that is,the ioduretted ointment is rubbed into the affected part, without theepidermis being previously removed. On the agency of galvanism inpromoting the passage of iodine into the system, I have already madesome observations (see pp. 55-6).

With respect to the internal use of this substance, some think that thesuccess depends on the use of small doses largely diluted,—while others