PREVENTION OF CRETINISM

Press, Volume LXXII, Issue 21867, 21 August 1936, Page 10

PREVENTION OF CRETINISM

Doctor Issues Strong Warning

CAUSES AND EFFECTS OF GOITRE

“We will, get cretinism in another 100 years if we do not do something,” said Dr. John Guthrie in an address on endemic goitre to the Canterbury centre of the Royal Sanitary Institute last evening, “Something can be done as it has been done in other places,” he said, “but in instances like this democracy is always the same. Every man on the street thinks he has the right to express an opinion whether he knows anything or not.” Dr. Guthrie said that he was not prejudiced against democracy it was better than some of the developments that had taken place in other countries. But in Germany the Government acted on the advice of those who thought; nobody else had any say. Vaccination against smallpox was compulsory, and to prevent another disease, raw pork was not allowed'to be sold. Dr. Guthrie said that most of the foundations of goitre were laid before the child was born. This was one of the things that . hastened cretinism, and it would come it something were not done very scon. He described the characteristics of cretinism as found in such places as Switzerland. These included dwarfing caused by the stoppage of growth through the thyroid gland ceasing to function, and effects on the hair and the conformation of the face, which was incapable of expressing emotion. Regions of lodine Deficiency

Goitre, said Dr. Guthrie, quoting an authority, was an iodine deficiency disease associated with the geological formation of the surroundings. It was to be found in the watersheds of all the great alpine chains throughout the world, in Switzerland. Austria, Savoy, Northern Italy, and Southern Germany. The iodine deficiency, however, was only one of many causes. In the Himalayas, goitre had been found in conjunction with contaminated water. Psychic shock, fevers, and the strain put upon the thyroid in growth and various other circumstances were other causes. In- Canterbury, he said, not every one had goitre, but there was the predisposing cause. The Canterbury plains were alluvial in formation, and the iodine, which existed in the earth s crust in a soluble form, had been washed into the sea. Life had begun in the sea. and certain substances to be found in the sea were still needed by animals which had taken to the land. lodine was one of these, and it was the'function of the thyroid gland to seize iodine from the biood stream, hold it, and manufacture thyroxine to send back into the bloodstream whenever it was wanted. When this occurred the effect was to raise the energy in every part of the body. Where the action of the thyroid was cut out cretinism resulted and growth was aborted. In later life the subject affected developed gressness, the tissues became swollen, and rolls of fat were put on. These conditions had been treated with miraculous results with thyroid from sheep. ' , Some goitres were chronic and harmless. but some were toxic. -In some cases goitre and Graves disease were developed suddenly by a sudden shock. In time all goitres became toxic. Goitre Unknown to Maoris

' Dr. Guthrie said that goitre was unknown to the oua'Maoris, and curing all his experience he had only come across one Maori with goitre, and she had been adopted when young by white people, and had become accustomed to their foods. Fish, shellfish, and kelp, which contained iodine, were a large part of the diet of the Maoris, whereas in the diet of the European there was an enormous variety of foods for the body to deal with, compared with the uniformity of the primitive diet. He added later that shellfish and oysters had the highest iodine content, though eels, which the Maoris ate, did not contain much ioume. Slides were shown of cases of goitre, in which, said Dr. Guthrie, the thyroid gland had become enlarged through an everlasting struggle to obtain iodine. Referring to the administration of iodine in the treatment of goitre. Dr. Guthrie said that in the form of iodised salt it could do no harm, and possibly might do a lot of good, as the amount of iodine was much smaller than the amount used therapeutically by doctors. In the case of children, the enlarged gland might‘be reduced by judicious iodine treatment under the supervision of doctors. In the case of exophthalmic goitre it was of temporary benefit before operations. Apart from hose two cases the danger of iodine treatment was that it disturbed the gland and made it hyperactive and more toxic.