GOITRE IN OTAGO

Abstract

Summary1. A study is presented of 368 cases of thyreoid disease observed a t the Dunedin Hospital over a period of six and three‐quarter years.2. Simple and toxic goitre' occurred in approximately equal pro‐portion, but many of the simple cases presented features of “border‐line” toxicity.3. The difficulties of accurate classification, particularly in the toxic classes, are discussed and arguments advanced for the abandonment of the differentiation “primary”) and “secondary”4. The family history in all classes (least marked in the primary Graves's disease group) indicates the high family incidence of goitre in this district.5. The results of surgical treatment in toxic goitre are excellent and compare favourably with those in other important disease groups, such as biliary.6. The operation mortality in toxic cases was 3.770.7. An unduly high incidence of recurrent laryngeal nerve lesion 8. Poxt‐operative myxoedema in classical form was noted in three.8. Poxt‐operative myxoedema in classical form was noted in three cases out of 319 operations in all classes.9. Tetany occurred in three cases in the same series.10. Our biochemistry findings indicate that the blood iodine content is higher in primary Graves' disease than in simple goitre, and that the iodine content of blood, urine, fsces and gland are all lower than normal in simple goitres.11. Observation of our cases leads to the conclusion that the histological picture merely represents innumerable variations of one and the same pathological process of involution and hyperplasia. It is impossible accurately to correlate the pathological picture with the clinical classification. after operation is recorded. cases out of 319 operations in all classes.