Goitre in the Schools—High Percentage

Kai Tiaki : the journal of the nurses of New Zealand, Volume XVII, Issue 3, 1 July 1924, Page 113

Goitre in the Schools— High Percentage

The Medical Conference, at a special meeting, discussed the alarming incidence of goitre m New Zealand. In a paper reviewing the situation, Professor Hercus, of Dunedin, attributed the prevalence of the complaint to the absence of iodine m water, and condemned the absence of iodine m refined salt, with the result that the conference carried a resolution instructing the council of the British Medical Association to bring before the Government the urgent necessity of enforcing the inclusion of iodine to table salt. Dr. Ada Paterson, reporting on the findings of school medical officers, said that m 1912 and following years little attention was paid to goitre, only those cases being recommended for treatment which showed definite constitutional disturbances. Recently the subject had been more seriously regarded owing to the growing significance attached to the functions of the endrocrine glands. In the last three years comprehensive records have been made, cases investigated by Professor Hercus and Dr. Baker m Canterbury being classified m the incipient, slight, medium, or large forms. In all, 19,930 children were examined, the result showing that 15.73 per cent, were affected m varying degrees, the incidence bcin^ greatest as the higher standards were reached. In Canterbury, m the primer classes, there was little difference m the incidence m boys and girls, though at adolescence the percentage of boys affected decreased, the incidence m girls being as two to one. The treatment of children at school had been sufficiently encouraging, and facilities were now provided by which all schools m endemic areas might obtain treatment, consisting m the administration of minute doses of iodine weekly for three school terms of eight weeks each, whilst advice was also given on general health habits, more particularly m the avoidance of constipation and the use of wholemeal bread and plenty of fresh vegetables.

Professor Hercus said that goitre was common m all countries, and was known to exist 2000 years before the Christian era. Though it was difficult to convince the public, because there was no pain, of the seriousness of the complaint, endemic goitre was insidious to a degree. Deformity, sallow skin and dullness were some of its effects m New Zealand, but it was m the generations yet unborn that its Cull significance would be founu, for the dictum of Morel was that goitre was the first halting-place on the road to that form of idiocy known as cretinism. In the population of 3,000,000 of Switzerland there were no less than 12,000 cretins and cretinoid idiots. The settlement of New Zealand was too recent for such an incidence here, but already, after three or four generations, cretinism w r as making its appearance. Only a few cases were enough to point as a finger-post to the dangers of the future. , It was an alarming fact that m Standards V and VI m a large school m Christchurch there was a goitre incidence of 4^ .per cent.

Dr. Hercus dismissed the theory that goitre was water-born, unless it was that the factor was the absence from and not the addition of some substance m the water. This fact was well illustrated m Christchurch, when the low incidence of 14 per cent, of goitre was found m Heathcote, against 60 per cent, m Woolston. The artesian water at Heathcote was shown to be mixed to some extent with sea water, and sea water contained iodine. "Goitre," said Professor Hercus, "is simply a compensating reaction, a symptom depending immediately, if not remotely, on a lack of iodine. Whatever may be the ultimate cause, the immediate cause of the enlargement is an iodine deficiency." He contended that evidence supporting this conclusion was incontrovertible, and that the active hermone of the thyroid was a very stable compound of iodine, and no goitre would develop if the iodine content of the thyroid were maintained.

The professor pointed out that the snow-fed water supplies, such as those at Christcmirch, were deficient m iodine, and that the iodine content of the soil m the great lowlands of Canterbury and Southland was low or deficient; thus the iodine content of the food raised there was low. The State could not afford to leave the supply of such deficiency to the capi'ice of parents, when the result was of such significance to future generations. Even if the State gave all school children the iodine treatment, it was confining its efforts to a limited portion of the community and leaving alone the equally im-

portant group between the ages of ii and 25. The remedy suggested was either the addition of the necessary iodine to water supplies or its retention m salt up to a certain proportion. The ordinary table suit of to-day contained 99.80 per cent, of sodium chloride. It was too refined and eliminated from the crude article substances, including iodine, which had the highest dietic constituents. Dr. J. W. Mayo endorsed the conclusions of Professor Hcrcus and Dr. Baker, and at the end of the ensuing discussion the conference carried its resolution m regard to table salt. — "Auckland Star."