The following instance of transmission of goiter through four generations is of interest, especially in this country, where the endemic causes of goiter do not seem to be present:
—Pauline M., 18 years old, was admitted to the surgical service of the Moses Taylor Hospital on account of an enlargement of the thyroid gland which had been present about four years. During the last three months she had had considerable dyspnea and discomfort from the tumor. The right lobe and isthmus of the gland were removed, and on microscopic examination proved to be of typical parenchymatous structure. The patient made an uninterrupted recovery. The following notes show the course of this disease through the family.
—The patient, Pauline M., as above noted. A brother, aged 19, has a symmetrical swelling of the thyroid gland which causes considerable dyspnea. A sister, 16 years old, has a marked enlargement