The broad ax., 1921-12-17

although we cannot assert that they
are causal independent of other more
essential factors. There is a wide
spread belief among physicians that
the cause is in some way related TO
drinking water.
While it is not our purpose to go
into details as to treatment, perhaps
it may be profitable to present a few
suggestive facts about the approved
methods OF handling the disease.
From what has been said, 1t will be
easily understood that there is no one
method suitable for all types of goiter.
| wish to nphasize this point above
all others In the way of medical
treatment iodine, or some preparation
of it. properly given under the direc-
ton of the physician, is OF immense
value in the prevention and cure OF
goiter in early life. Other drugs are
beneficial in relieving symptoms. A
goiter should not be painted with
any drug or chemical whatsoever.
There is no successful serum or vac
cine, although several dozen kinds OF
them have been tried. Many golfers
are reduced, and some yield completely
to X-ray therapy That wonderful
substance, radium, about which we are
hearing so much at the present time,
has to its credit many good results. To
the uniformed it should be stated that
while both these latter agencies have
great powers for good in appropriate
cases, and administered by experienced
hands, they also have possibilities for
harm. and the physician should de-
eide the best method for the particular
case. In not a few instances. there is
no apparent urgent reason for inter
ference of any kind. There may be no
pressure symptoms, such as difficulty
in breathing, or in swallowing. nor
evident effects of poisoning. But DR..
Plummer, chief medical doctor OF the
Mayo clinic has demonstrated by sta
tictics of thousands of cases carefully
studied, that a patient having a simple
goiter starting at about %. has a very
definite chance of that goiter becoming
toxic at about SO. In other words,
every simple goiter untreated tends in
about fourteen years. to become a
serious disease. Upon these facts, we
base the plea that all golfers should
have competent medical advice even
though they appedI SyHIptUInIeSs.
1t is fairly agreed by medical as well
as surgical doctors that the large
or cystic goiter can only be
removed by surgical means Our peo-
pie have an altogether unwarranted
fear of operation in the simple goiter,
A fear perhaps encouraged by some
physicians. ] am free to say that with
the exception of very long standing
toxic and complicated cases. there are
few major surgical procedures that
can be done with less risk and greater
both to patient and ply
SiCian; this, OF course, on the condi-
lion that the work is done by those
who have acquired the special expert
ence and skill to do it. Most cases can
low be done under local anesthesia:
hat it. a painless operation can be
lone without putting the patient asleep
With ether. The scar following a prop
.rly done goiter operation is as a rule
practically invisible. OF course. as has
'een stated, many cases do not re-
luire operation; and there are some
others that though they need it. have
through ignorance and fear permitted
he golden moment to pass when OPP
ration could have been done with
afety. Especially is this true of the
ind occurring in young and middle
ged women land occasionally in
1en), with the staring eyes, which we
ave referred TO as "exophthalmic
otter" This disease although prim-
rily of the thyroid gland, affects all
ne tissues of the body, particularly
ne heart and the nerve tissues. 1t is
pit to come on in waves, or spells;
nat is to say, there are periods when
lie patient for several weeks or months
,els so much better that she thinks
he is we'll, only to be followed by
mother period OF serious nervousness,
alpitation, loss of weight. etc. This
eriod of improvement may occur re-
ardless of what is or is not done in
lie way of treatment. so II is easy to
e that whatever medicine was given
Or if the patient went into Science"
about that time), such got credit
" the apparent cure. Rest and quiet
-e of the greatest Importance for
lese patients; in many instances Of
ore importance than drugs. They
lould be handled sympathetically by
mily and friends. and protected from
yery thing that would tend to worry
; irritate; for many cases are known
have become fatally worse following
severe emotional shock. The high
t type of training. experience and
dgement are demanded of the medi-
I adviser here I shall not CO f,,-