Thyroid Goiters 101: Early Records What did We Learn?
Today we still use iodine for endemic goiters, thyroid hormone , and ethanol for ablation of thyroid cysts and small primary thyroid cancers. After all these years surgery is still the most recommended treatment for goiters.
Cystic Goiter above could be treated today with Ethanol Ablation PEI.
The American Thyroid Association was founded by surgeons in 1924 to treat goiter. It was called American Goiter Association.
First regular program Meeting, American Association for the Study of Goiter
Hotel Illinois, Bloomington, Illinois – January 23-25, 1924 The first session convened at St. Joseph’s Hospital, 7:45 a.m, January 23. The program committee announced that they felt justified in featuring ethylene anaesthesia at this annual meeting in view of the fact that it is attracting great interest at the present time and it was so satisfactory at the preliminary clinic held December 17. OPERATIVE CLINIC: Held by Dr. E. P. Sloan, assisted by Drs. G. A. Sloan, Herman Wellmerling, J. D. Moschelle, and Geo. Newell. Four patients were operated under nitrous oxide oxygen anaesthesia, administered by Dr. Wm. Young. Four patients were operated upon under ethylene oxygen anaesthesia, administered by Dr. Dennis Rupp, assisted by Mr. P. J. Me–Curdy of the Safety Oxygen Gas Machine Company. The anaesthesia was featured and comparison of effects of nitrous oxide and ethylene was made. It was obvious that ethylene is more potent than nitrous oxide, that the patients are anaesthetised quicker and recover normal consciousness sooner than after nitrous oxide.
Surgery was the main treatment.
Here is a list of non -surgical therapies from 18770.
- Move away from goiter area.
- Stop drinking water or boil it.
- Avoid exercise that leads to a hyperemia of the neck
- Move to the seacoast.
- Iodine given as a powdered sponge.
- Iodine applied to the neck, by injection or by mouth.
- Bandage soaked in 20% KI during sleep only to avoid skin staining.
- Salve with 3% Biniodid of Mercury.
- Iodoform ointments.
- Lugol’s solution in small doses.
- Sheep thyroid injections decreased goiters.
- Thyroid tablets improved the goiter in 50%.
- Thymus injections for goiters.
- Iodine injections directly into the thyroid goiters.
- Iodine,ether, olive oil solutions.
- Alcohol injections for goiters. Well we use it today as ethanol ablation PEI.
- Surgery relieved stridor and corrected vocal cord paresis in large goiters.
- Removal of the thyroid gland was considered one of the most dangerous surgeries.
- With antisepsis, and asepsis, special techniques and recognition of tetany and hypothyroidism post op the death rate plunged to lower levels.
- The death rate decreased to 3%. Today the rate is too small to calculate, but complications are still a problem.
- Infection was the most dangerous post op complication.
- Tracheotomy used today with success for post op bleed was universally fatal from septic shock.
1897 Syphilitic Infection of the thyroid treated with thyroid extract.
- 1898 Congenital Syphilitic struma of the thyroid.
- 1870 thyroid cancer growing into the Trachea.
- 1870 thyroid cancer in a bronchocele.
- 1875 thyroid cancer in bone,esophagus
- 1898 patient suffocation to death from thyroid cancer in the trachea.
- 1865 Complete calcification of the thyroid gland.
- Lombard, 1859, reported a case of rupture of thyroid, resulting in cystic goitre.
- Nicholls, 1869, reported a sudden death by cystic goitre.
- Holbrook, 1817, made observations on the cure of bronchocele (Goiter) by pressure.
- Meissner, 1829, was among the ﬁrst to mention a blood cyst of the thyroid gland.
- At the Pathological Society, London, 1867, a living specimen of blood cyst of the thyroid was exhibited.
- the thyroid gland complicating the convalescence of typhoid lever. Lemarie, 1889, described inﬂammation.
- Albers, 1847, observed tuberculosis of the thyroid gland,
- Tapping is only applicable in cystic goitre, and there only successful when the fluid is of a watery ch-rncler. The denser ﬂuids will not flow through a trorar.
- A large bronchocele Goiter was removed with fatal result.
- Vascheli, 1887, reported a case of cystic goitre treated by “ shelling out.”
- Wahltuch, 1871, successfully treated a case of bronchocele by electrolysis and the subcutaneous injections of iodine.
- Meyer, 1874, applied galvanism to the sympatheticus in a case of exophthalmic goitre.
- No form of electricity should be employed in the treatment of goitre. It is more injurious than beneﬁcial, especially in the event of subsequent thyroidectomy, as it causes more or less adhesions, which renders the operation more diﬁicult.
- Haddeu, 1887, treated exophthalmic goitre with the continuous current,
- in a case of goitre. Juettner, 1890, wrote on the thyroid gland, the neurotic character of its enlargements, and the relative value of the galvanic current in their treatment.
- Carless, 1894, operated for cystic tumor of thyroid; death from sudden dyspnea