甲状腺
1.I have lately seen three cases of violent and long continued palpitations in females, in each of which the same peculiarity presented itself, viz: enlargement of the thyroid gland...it was observed that the eyes assumed a singular appearance,for the eyeballs were apparently enlarged, so that when she slept or tried to shut her eyes, the lids were incapable of closing.
—— Robert J.Graves, 1796——1853
【译文】最近，我看到3例持续剧烈心悸的女性（患者），每一例都表现出相同的特点，即：甲状腺肿大……并观察到她的眼睛呈现出奇特的外观，因眼球明显外凸，以致在她睡觉或试图闭上眼睛时，眼睑竟无法闭合。
【点评】这就是典型的Graves病。
2.No sensible man will, on slight consideration, attempt to extirpate a goitrous thyroid gland.If a surgeon should be so adventurous or foolhardy as to undertake the enterprise, I shall not envy him his feelings while engaged in the performance of it, or after he has completed it, should he be so fortunate as to do this.Every step he takes will be environed with difficulty, every stroke of his knife will be followed by a torrent of blood and lucky will it be for him if his victim lives long enough to enable him to finish his horrid butchery.
—— Samuel Gross, 1805——1884
【译文】没有哪一位明智的医生会轻率地试图去切除甲状腺肿。如果一位外科医生敢于冒险或鲁莽地逞英雄，即使他幸运地做下来了，我也不会嫉妒他在手术时或是手术完成后的那种感受。手术的每一步都困难重重的，动每一刀都会伴随着泉涌般的出血，如果受害者能够坚持到这个可怕的屠戮完成，那也将是他的幸运。
【点评】那个年代做甲状腺切除手术的确是一场灾难。据文献记载，19世纪后期，Kocher开始对甲状腺疾病进行系列研究时，甲状腺切除手术的死亡率大约为1/6。经过他的努力，后来在他手中的死亡率降低至1/500。由于他在甲状腺生理学和外科学方面的开创性工作，Kocher在1909年获得了诺贝尔奖。
3.The extirpation of the thyroid gland typifies, perhaps better than any operation, the supreme triumph of the surgeon’s art.A feat which today can be accomplished by any competent operator without danger of mishap and which was conceived more than one thousand years ago might appear an unlikely competitor for a place in surgery so exalted.
—— William Stewart Halsted, 1852——1922
【译文】甲状腺切除，也许没有任何手术能比它更能代表外科医生技艺的最高成就了。然而今天，任何一名真正合格的术者都可以完成这一壮举而不会发生任何不幸，或许看上去这个手术在外科不至于有如此崇高的挑战者地位，可是它是 1000 多年前构想出来的！
4.As the result of needle biopsy to establish the diagnosis and the use of suppressive doses of thyroid hormone to treat benign goiters and struma lymphomatosa, and the use of corticosteroids to treat subacute thyroiditis, we have practically abolished thyroid surgery ...the number of thyroid operations performed at the Cleveland Clinic fell from 2700 in the year 1927 to less than 50 a year.
—— George Crile, Jr, 1907——1992
【译文】通过穿刺活检结果可获得确诊，用抑制剂量的甲状腺素可治疗良性甲状腺肿和淋巴瘤性甲状腺肿（又称桥本甲状腺炎），用皮质类固醇可治疗亚急性甲状腺炎，由于这些进步的出现，我们已在实践中废除了甲状腺手术……克利夫兰诊所的甲状腺手术数量已从1927年的2700例下降到如今每年不到50例的状况。
【点评】外科疾病转为内科治疗的典型。
5.Recurrent laryngeal nerve damage produces voice changes, but not choking;they graduate in the choir from singing Ave Maria to Old Man River.
—— David Dent
【译文】喉返神经损伤导致声音变化，而非窒息；他们从唱《圣母颂》转到唱《老人河》，因而从唱诗班毕业了。(https://www.daowen.com)
【点评】说的是一侧喉返神经损伤，如果双侧损伤也有导致窒息的可能。
6.His pre-op thyroid surgery counseling included: "Madam, this operation will make you hoarse and cough like a cow."
—— Dr.Frascani
【译文】甲状腺手术的术前知情同意应包括：“女士，这个手术会让你声音嘶哑和像牛一样地咳嗽。”
7.Recurent nerve at thyroidectomy: not seen, not caught.
—— Bernard Cristalli
【译文】甲状腺切除术中的喉返神经：没见到就没有伤及它。
【点评】30多年前我学做该手术时，老师就是这样教我的。然而现在，随着手术技术的进步和神经探测仪的出现，该原则不再被奉为甲状腺手术中喉返神经保护的唯一信条。
8.Looking for the recurrent laryngeal nerve after previous thyroidectomy has all the sensitivity of detecting a landmine in Angola.
—— David Dent
【译文】在既往有甲状腺切除手术史的患者，寻找喉返神经就要有像在安哥拉探测地雷那样的全方位敏感性。
【注】在安哥拉反对葡萄牙殖民统治和随后的国内战争期间，埋下了相当多的地雷。据国际媒体谨慎的估计，安哥拉境内有将近500万颗地雷。让这个非洲国家成为世界上蒙受地雷危害最严重的国家之一。
9.It seems hardly credible that the loss of bodies so tiny as the parathyroids should be followed by a result so disastrous.
—— William Stewart Halsted, 1852——1922
【译文】近乎难以令人置信的是，像甲状旁腺如此微小的一块组织丢失、会导致如此灾难性的后果。
10.The clinical presentation of HPT in the early stages is rare.Later, it may include renal calculi, osteoporosis, peptic ulcers, pancreatitis or neuropsychiatric symptoms which is classically described with the pneumonic "painful bones, renal stones, abdominal groans, and psychic moans".
【译文】甲状旁腺功能亢进症（HPT）早期几乎很少有临床表现。后来，它可能包括肾结石，骨质疏松症，消化性溃疡，胰腺炎或神经精神症状，可以用顺口溜来描述这些典型的症状：“骨头痛、肾结石、腹部不适还有不少心理抱怨”。