HEALTH NOTES.

Waikato Times, Volume 108, Issue 18165, 1 November 1930, Page 5

HEALTH NOTES.

;i GOITRE PREVENTION. d r USE OF lODISED SALT. 1, s! (Contributed by the Department of c (Health.) o d “It Is extremely disappointing e I to find that such a small peroenty age of the people In affected areas h ! are using the safe and effective d prophylaxis which the use of lodized salt affords.”—Professor d C. E. Hercus, ih his preface to t Goitre in School Children in Cery tain Districts of the North Island of NVw Zealand,” by Dr. R. A. e Shore and R. L. Andrew, Analyst. s Goitre is the term applied to enj. | largement o'f the thyroid, a gland ? ; which is situated in front of the neck, j There are various types of goitres, the principal being:—(l), Simple goitre, which is defined as an enlargement of the gland, such enlargement being of normal gland tissue, and 5 functioning normally; (2), vadenoma- - tons goitre, where the enlargement t i combines poisonous goitres; these 3 J may produce most dangerous amounts 1 : of poison without much enlargement, t i Though these types are separately de- ■ | scribed, they seldom occur separately. • I The so-called simple goitre nearly al- > ! ways has fibrous or cystic degenera- ■ lions, and is always likely to develop them, simple enlargement being the ■ precursor of any of the other fprms. J Distribution. ! ' Endemic goitre is found in well-de-fined 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 boys and 26 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, as is well known, normal glands in non-endemic areas may become sufficiently enlarged at this period to be readily palpable. It is not surprising, therefore, to find a marked increase 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. While this diminution in the 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 has been put forward —namely that goitre is not due to anything which is in the water, hut to a lack of something in the water or the soil or the foodstuffs grown with that soil and water, namely, to a deficiency of iodine. lodine is invariably present in thyroxin, and iodine lias 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, where goitre was so bad that it threatened the sheep-raising 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. These salt-licks, 1

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 lowiodine area and high-iodine area is too 1 insignificant to be a mere coincidence and It was concluded that the amount of iodine avilable does apparently exercise a predominating influence on the incidence of goitre.

Prevention. Thus it is evident that whether or not iodine deficiency is the whole cause of endemic goitre, it plays a very large part. This being the case, it is the custom to recommend the use of iodized salt for all cases of goitre found amongst -school children during medical inspection. The intensive propaganda carried out in Canterbury for the past ten years, resulting not only in the earlier remedial, but in general preventive measures such as a wide use of iodized ! salt, is now having a beneficial effect. Since 1920 the total number of normal thyroids has in Christchurch, Timaru and Ashburton increased 13 per cent to 25 per -cent. The improvement manifested in these figures is due to an all-round improvement, hut is chiefly manifest in the small, medium and large goitres—this is, in the more serious types. Two points, however, must be 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 it lias been estimated that two oysters every day will keep*, goitre away; but an ounce of kelp is even 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.