Cheever1 voiced a universally approved sentiment when he stated that operations for hyperthyroidism will always be attended by a peculiar factor of danger not present in other procedures that are technically similar. I have, with this in mind, chosen a definitely limited field in thyroid surgery in order that the subject may be viewed from as many different angles as possible and in rather minute detail. One's personal experience seems to be reflected most adequately by considering this clinical material under the following headings: diagnosis; patients unsuited to operation; preparation for operation; the impossible patient; the patient who is ready; when to operate.
A sharply defined diagnosis of exophthalmic goiter is generally accepted by surgeons of the representative goiter clinics in our country and abroad. Wilson states, however, that 30 per cent of the hyperplastic thyroids in the Mississippi Valley states present multiple adenomas; hence one is, I