HEALTH NOTES

Patea Mail, Volume LII, 2 January 1931, Page 4

HEALTH NOTES

GOITRE prevention. USE OF lODISED SALT. (Contributed by the Department, of Health). Jt is extremely disappointing to And that such a small percentage of the people in affected areas are using the safe and effective prophylaxis which the use of iodised salt affords —Professor C. E. He reus, in his preface to "Goitre in School Children in certain districts of the North Island of New Zealand,” by Dr. R, A. (Shore and I!. L. Andrew, analyst. Goitre is the term applied to enlargement of the thyroid, a gland which is situated in front of the neck. There tiro various types of goitres, the principal being (1) simple goitre, which is defined as an enlargement of the gland, such enlargement being of normal gland tissue, and functioning normally; (2) adenomatous goitre, where the enlargement combines poisonous goitres; these may produce most dangerous amounts of poison without much enlargement. Though these types are separately described, they seldom occur separately. The so-called simple goitre nearly always has fibrous or cystic degenerations, and is always likely to develop them, simple enlargement being the precursor of any of the other forms.

DISTRIBUTION. Endemic goitre is found in well de'in(><l areas of ’the earth's surface. In New Zealand, as a result of the examination of 24,000 children, it was found that 24 per cent, of the hoys and 20 per cent, of the girls examined showed some degree of goitre. Puberty is the period of the greatest functional activity of the thyroid gland, and, ais well known, normal glands in nonendemic areas may become suficiently enlarged at this period to be readily palpable. It is not surprising, therefore, to find a marked increases in the incidence of goitre in both sexes as puberty approaches. The marked diminution in the size of the goitres, which is more clearly marked in males, in the post-puberty period is clearly indicated, mile this diminution in tin' incidence of goitre and in the size' of the persisting goitres is a gratifying feature of the results of the examination of these children, unfortunately there is abundant* evidence that a large number of the goitres persist, many to give trouble later in life. CAUSE. Within recent years a theory habeen put forward, namely that goitre is not duo to anything whirls is in the water, but to a lack of something in the water or the soil or the foodstuff:grown with that soil and water, namely to a deficiency of iodine. lodine is invariably present in thyroxin, and iodine has been found to be the only drug which has any consistent success in the treatment of goitre. In the Great Lakes Basin of America, an endemic goitre area, whore goitre w r as so bad that it threatened the sheepraising industry, it was noticed that sheep free from goitre introduced into this endemic area, as long as they had access to certain salt licks, remained free from goitre, and so did lambs. Those salt licks, when analysed, proved to be rich in iodine. In a recent investigation in 'New Zealand among children it was found that the great difference between the incidence of goitre in a low-iodine area and highiodine area is too significant to be a mere coincidence, and it was concluded that the amount of iodine available does apparently exorcise a predominating influence on the incidence of goitre.

PREVENTION. Thus it is evident that whether oi not iodine deficiency is the whole cause „C endemic goitre, it plays a very large part. This 'being the case it is the custom to recommend the use of iodised salt for all eases of goitre ioumi amongst school children during medical inspection. The- intensive propaganda carried out in Canterbury for the past ten years, resulting nob only in the earlier remedial but in general preventive measures such as a. wide use of iodised salt, is now having a beneficial effect. Since 1020 the total number of normal thyroids has in Christchurch, Timam, amt Ashburton increased 13 per cent, to 25 per cent. The improvement manifested in these figures is due to an all round improvement, but is chiefly manifest in the small, medium, and large goitres—this is, in the more serious typos. Two points, however, must he made clear. The,first is the minute quantity of iodine needful for the prevention of goitre in a normal thyroid. It is less than the equivalent of three dried sago grains a year. -So minute is the needful quantity that if has been estimated that, two oysters every day will hoop goitre away; but an ounce of help >s oven better. In the second place, while, iodine in small doses will prevent goitre in individuals with normal thyroids, and is known to act beneficially in numberless cases of children with enlarged thyroids, it is inadvisable to recommend its use indiscriminately and without medical advice. This is especially true of adults with diseased thyroids, who should take iodine or any other drug only under the direction of a physician, ______