ingr of the surface generally follows,a second application of the ointment is made, and the patient sent home. This is often found sufficient to effect the cure, but the treatment
can, if necessary, be repeated.The name “ Exophthahnic Goitre ” is applied to another form of enlargement of the thyroid gland, differing entirely in its pathological Connexions from that above described. In this affection the bronchocele is but one of three pheno- mena, which together constitute the typical characteristics of the disease, viz., palpitation of the heart and great vessels, enlargement of the thyroid gland. and protrusion of the eyeballs. This group of symptoms is generally known by the names of Graves’s disease or You Basedow’s disease, in reference to the physicians by whom the malady was originally recognized and described. Although occa- sionally observed in men, this affection occurs much more -commonly in females and in comparatively early life. It is generally preceded by ill health in some form, more par- ticularly impoverishment of blood, and nervous or hysterical disorders, and is occasionally seen in cases of organic heart- disease. It has sometimes been suddenly developed as the effect of fright or violent mental emotion. The first of the symptoms to appear is usually the palpitation of the heart, which is aggravated by the slightest exertion, and may be so severe as not only to shake the whole frame but even to be audible at some distance from the patient. An uncom- f ortable sensation of throbbing is felt throughout the body, and many of the larger blood-vessels are seen to pulsate strongly like the heart. The enlargement of the thyroid gland generally comes on gradually, and rarely increases to any great size, thus differing from true goitre, as originally noticel by Dr Graves. The enlarged gland is of soft con- sistence, and communicates a thrill to touch from its dilated and pulsating blood-vessels.
Accompanying the goitrc a remarkable change is observed in the appearance of the eyes, which attact attention by their prominence and the startled expression thus given to the countenance. In extreme cases the eyes protrude from their sockets to such a degree that the eyelids cannot be closed, and injury may thus arise to the constantly exposed eyeballs. Apart from such risk, however, the vision is rarely affected in this disease. Much difference of opinion prevails as to the immediate cause of the protrusion of the eyes, but it is generally ascribed to the increase of the fatty tissue and distension of the blood-vessels of the orbits. 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, diarrhcea, and uterine derangements are common accompaniments.
The pathology of exophthalmic goitre is still somewhat uncertain, but there are strong reasons to believe that it is essentially a nervous ailment, and that the symptonn depend on a morbid state of the sympathetic nerve in the neck, which is well known to play an important part in the vaso-niotor functions—that is, in controlling the action of the heart and regulating the calibre of the blood-vessels. In numerous instances of exophthalmic goitre a diseased state of this ncrve has been found post mortem, although it must be admitted that in some cases no morbid change could be detected. The experiments of Bernard, Drown— Sequard, Schiff, and others upon the functions of the sym- pathetic nerve lend strong support to this view of the pathology of the disease. Exophthalmic goitre is not directly a. fatal malady, but, on the other hand, complete recovery is a less frequent result than partial improvement, the patient continuing to suffer from chronic ill-health. The disturbed condition of the heart’s action leads in some instances to permanent disease of that organ in the form of dilatation of its cavities. In the treatment of exophthahnic goitre the most successful results have been attained by the use of digitalis, which has the effect of giving tone to the heart and contracting the dilated blood-vessels. The tincture of digitalis, in doses of 5 to 10 drops twice or thrice daily, is perhaps the best form of administration. Where anaemia is present iron is indicated, and may be combined with the digitalis, although in some cases it is found to be unsuitable. In allaying the palpitation benefit is said to have frequently followed the application of ice to the cardiac region as well as to the thyroid gland. Iodine, which is so valuable in cases of true goitre, is generally admitted to be of no service in this disease, and is rather held to be injurious.
GOLCONDA, a fortress and ruined city, situated in the Nizam’s Dominions, 7 miles west of Hyderabad city. In former times Golconda was a large and powerful kingdom of the Deccan, which arose on the (low'nfall of the L’ahmani dynasty, but was subdued by Aurungzcbc in 1687, and annexed to the dominions of the Delhi empire. The fortress of Golconda, situated on a rocky ridge of granite, is extensive, and contains many enclosures. It is strong and in good repair, but is commanded by the summits of the enormous and massive mausolea of the ancient kings about 600 yards distant. These buildings, which are now the chief character- istics of the place, 1‘ am a vast group, situated in an arid, rocky desert. They have suffered considerably from the ravages of time, but more from the hand of man, and nothing but the great solidity of their walls has preserved them from utter ruin. These tombs were erected at a great expense, some of them being said to have cost as much as £150,000. Golconda fort is now used as the uizz’nn’s treasury, and also as the state prison. The diamonds of Golcunda have obtained great celebrity throughout the world; but they were merely cut and polished here, being generally found at Partial, near the south—eastern frontier of the nizz'un’s territory.
GOLD
THE colour, lustre, and power of resisting oxidation, which this metal possesses, have caused it to be valued from the earliest ages. Allusions to gold are frequent in the Old Testament, and the refining of the precious metals by cupellation seems to have been a favourite illustration with the Jewish pocts.[1] Jewellery and vessels ' found in Egyptian tombs afford evidence of the perfec- tion attained in working gold at a period earlier than the government of Joseph,[2] and drawings on tombs of about this epoch clearly indicate the method of conducting the operations of washing, fusing, and weighing the metal. Excavations in Etruria have brought to light beautiful ornaments of gold, enriched with minute grains of the metal, the workmanship of which was unrivalled until Castellani studied and revived the methods employed by Etruscan artists.[3] The Greeks were familiar with natural alloys of silver and gold named elerlrum, rough nuggets of which were frequently stamped, and formed the earliest coins in Lydia.[4] The colour of this clectrum is pale yellow to yellowish white, and it contains from 20 to 40 per cent. of silver.
