THE PROPHYLAXIS OF SIMPLE GOITRE.

Manawatu Herald, Volume XLIII, Issue 2241, 19 February 1921, Page 4

THE PROPHYLAXIS OF SIMPLE GOITRE.

The “Medical Officer” of the 30th October lasi draws-* attention to the interesting investigations .of Marine and Kimball, of the Y\ estern Reserve University, Cleveland, recently summarised in the “Journal of the American Medical Association,” on the prevention of simple goitre in man. In view of the fact of the existence of endemic goitre in certain districts of New Zealand the work of thes,e investigators is of special interest. • The article in question states as follows: — “Their $ work, aided by a grant from the American Medical Association. started early in 1917, with a survey of the incidence'and types of tbroid enlargement in the schoolgirls of Akron, Ohio, from the fifth to the twelfth grades inclusive. In the course of this they studied the value of the prohpylaetic use of iodide given in the arbitrary dose of 0.2 grm. (3 grains) daily for ten consecutive school days, repeated each spring and autumn. The latest report, X, including- the results of annual surveys over a period of thirty months, and involving many Iffncircds of children examined and treated consecutively, indicate a striking difference between those not taking and those taking iodine. The difference is manifested both in the prevention of enlargement and in a decrease in the size of existing enlargements —i.c., therapeutic effect. It appears to have been a successful experiment on a grand scale. Here are the facts brought out in the report: Of 2,190 pupils taking 2 grm. of sodium iodide twice yearly, 5 have shown enlargement of tlie thyroid, while 2,305 pupils not taking the prophylactic .195 have shown enlargement of the thyroid. Of 1,182 pupils with thyroid enlargement at the first examination who took the prophylactic. 773 thyroids decreased in size, while 1.0-18 pupils with thyroid enlargement at the-first-examination who did not take the prophylactic, 115 thvroids decreased in size.

“It might he supposed that toxic conditions such as give the symptom-- of hyperthyroidism would "(«■■ easionaiiy arise under the thciapy instituted; Iml. this does not seem to have been the ease. An occasional child may show signs of iodide rash, the treatment is stopped, ihe untoward effect of such iodine idiosyncrasy is negligible. In individual cases, on the other hand, the presence of pathological conditions may modify the usual efficiency of the prophylactic treatment.

“If the simple goitre of adolescence can he prevented easily and cheaply in otherwise normal per-

son-', it merely remains to secure public approval and systematic introduction of I lie procedure in those places where it seems indicated. Marine and Kimbcll conclude that in the region with which they have boon concerned, probably the maximum of prevention coupled with the luimimnm of effort would he obtained by giving iodide between the ages of eleven and seventeen yea is.

“It i.- becoming apparent that there is likewise a considerable incidence of simple throid enlargement in the .foetal period and in pregnancy. I liese are equally amenable to the corrective inlluence of iodide. Responsibility here clearly rests with the individual and the physician; but the. existence of an occasional need of iodine seems to deserve a wider recognition than it now ha.-."