PREVALENCE OF GOITRE

Timaru Herald, Volume CVIII, Issue 16820, 27 May 1919, Page 3

PREVALENCE OF GOITRE

OBSERVATIONS IN NEW ZEALAND A STRIKING ADDRESS. A striking address was delivered, at the annual meeting of the Dunedin Branch' of the Plunket Societj', by Dr. A. Murray Drennan (professor of pathology at the Otago University) on "The Prevalence of Goitre in New Zealand and Its Influence on the Coming Generation." He said that, while the New Zealand official mortality returns dealt with exophthalmic goitre (which was, not very common), no return at present showed the extreme prevalence of what was termed "simple goitre," especially in women. Goitre was a term applied to any form of enlargement of the thyroid gland in the neck, which, when it enlarged, caused an appearance popularly described as "thick neck." In a minor degree it was considered a mark of beauty, and was freely exhibited by th(> present fashion in female upper garments. After explaining the physiological changes in the thyroid gland leading to goitre, Dr. Drennan said that the . increased glandular activity which the condition most commonly resulted in caused a reversion to a resting state, with slight enlargement; "out sooner or later secondary changes occurred —hemorrhages, various degenerations, ere. The process might extend over a number of years, and not give rise to any particular trouble.; but it was always a ' potential source of trouble, and often of chronic invalidism. These changes were much more common in women. They were liable to commence at from 12 to 16 years of age, and increasing, cause trouble at the various momentous times which occurred in the female economy. The two most prevalent theories for the occurrence of goitre were (1) that goitre was in some way related to the water supply, and (2) that it was tin, result of infectious agents. Lieutenant-Colonel M'Garrison, of the 1.M.5., maintained that goitre was due to bacterial infection of the water supply, and brought out the fact that the children of goitrous mothers were frequently born defective, in a condition of cretinism, due to deficient thyroid secretion. s^"This is all very interesting." continued the speaker, "but you may ask "What application has it to New Zealand? In answer, I ask you to look with the seeing eye at the necks of the girls and women you meet in the streets of Dunedin, or. for that matter, almost any town in the Dominion. When I came here two and a-half years ago the first thing that struck me was the prevalence of goitre in women. 1 found myself anxiously regarding the necks—amply displayed—of all the women folk, and without exaggeration I feel safe in saying that at least one in ten showed a thick neck. I was told: 'Oh, yes, but that is physiological!' If so, the physiology of females here is something different from those of Britain. Vcrv soon I wn= satisfied < that it was a pathological problem on a large scale that was occurring. and every dnv strengthened that belief. The condition is so common here that it is regarded lightly or unnoticed.

In this connection certain questions at once arise: 0.) Whv are women especially affected ? (2) Why are not all women affected? (3) ,Is the offspring likely to suffer? In answer to the first, women ask more of their thy- . roids, and the gland responds normally or abnormally .depending on its supply of raw material, which may be deficient of; alter.pd by -various factors. The first abnormal resoon,se is the 'beginning a goitra. (2) Only a proportion li'it a larse proportion, of women are affected, because individual conditions vary considerably; and probably here wo are dealing with a relative and not an absolute deficiency or disturbance. The offspring is undoubtedly affected, directly or indirectly, by anything interfering with the health of the mother.' The exact amount of damage to the future generation in New Zealand by ' this prevalence of goitre cannot as yetjbe estimated, for we have not the data as yet: but, judging by analogy, the possibility of deterioration is great. « "What is one to suggest to combat this menace? The'.'first thing is accurate observation and research on the data available here, "but* from the extsnsive researches mainly in America the basic fact seems to stand out that we are suffering from- a widespread efficiency disease, a deficiency' primarily of iodine—whether in its" mode of intake or mode of utilisation i n the body I cannot tell you. Whether the result of investigation into goitre will show • that a more hygienic mode of life is all that is required for avoidance of this goitre,' or that som e deficiency, such as I have indicated~\ e xists in the food intake, can be decided, only by carrying through the investigation. A priori, ,one would be inclined* to think that something more than mere hygenio measures are required in New Zealand, for here the conditions are similar, but generally better than those in the Old Country, while goitre is infinitely more common here. "The motto of this society j s "To help the mothers and save the babies.' But mors is required. We here in New Zealand are too prone to take knowledge second-hand a.nd try to apply it to our conditions without first investigating these conditions. We have here a virgin soil, for research in many directions, and if we are to advance w-s must probe our problems first-hand, aided certainly bv the knowledge 'gained from other lauds. This society deals with the mother and the babies, but what of the babies till they become mothers? What of the growing children, the young adults, and even the mere men? To restrict the matter to the subject in hand, we have here an excellent opportunity for combined effort. This society originated in this academic City of Dnnedin. and so also the only Medical School of the Dominion arose, and is growing here. It is popularly regarded as primarily an institution for instructing students in the art of curing disease. It ought to be the centre of original investigation into the particular New Zealand problems of health and disease In conjunction with the Health Department, it should strive to show how illness may be prevented, not merely how the damaged may be patched. To carry on such investigations as are requisite, workers,' time to work, and funds are needed on a large scale. That is, where America scores. She recognises the need, and her Government and millionaires supply the ammunition. The gunners, in the form of scientific workers, are thus enabled to keep on firing till the enemy is demobilised. We should, and can, do likewise, if only we recognise the need for such expenditure of energy and money. With certain notable exceptions, neither has been much in evidence up till now, but that is not altogether the fault of either the people of the Government. Tho need, until recently, has not been properly recognised or concretely presented' by the medical profession to th e people—l speak here only of medical problems. 'ln the domain of concrete thingsagricultural and industrial problems—the people and the Government are quick to act. But if some tens of thousands of women are affected with goitre, each an actual or potential <.-r>us;> ol- illness with consequent inefficiency ;md loss of energv, are a potential menace to the welf-being of tho next generation, it doesn't matter! Why. waste time or money on such a. vague matter! Let us abolish alcohol and all will be well! And we j .call this a progcejalve couotiS— flpd'sj!

own country I believe it is termed;! The Lord helps those who help themselves! Surely health comes first, and health means primarily the prevention of illness,' and any society, any work, any investigation that is necessary to safeguard or improve health ought to Come first, and ought to be fully and amply supported. The immediate financial return may be a minus quantity, but the future gain to the people will more than repay all that is spent." DR. FITCHETT'S ARRESTING ENDORSEMENT. Dr Fitehett, in moving a vote of thanks to the lecturer, ho 1 did not think that Dr Drennan had been over-estimating the prevalence of morbid conditions of the thryroid in New Zealand,, nor the menace they offered to present and future generations. "In plain language, would I say," said Dr Fitehett, "that many of yoii here—there are plenty of subjects present—are victims of goitre, and as subjects of goitre you are potential invalids. Th e condition in this simple form does not carry with it anv arresting symptoms; but probably, as subjects of goitre, you are more or. less invalids now. You are not so robust or so vigorous as if your necks were of normal The 'pleasins: swelling' is in renlitv a. disease—a. disease, however, which offers a greater prospect of eradication than manv others with which we are familiar if we knew its cause. Dr. Drennan lias said that on e of the causes is deficiency of iodine _ But we do not know whether there is not enough iodine in the body, or whether there is a deficiency thereof in the food, and it ;s this we would seek to know. It is a matter which should appeal to the society, because there is no question that the disease is exceedingly prevalent. Tts investigation would cost money,but the siim required would 'he small compared with the danger to the State frorn thp prevalence, of '--these, -morbid conditions. In America-, for example, typhoid was estimated to cano?.. a loss tn the fitate of millions of dollars a year. Money spent on eradicating disease was money well spent."