- Email: [email protected]
Prevention of Goitre
913
Prevention of Goitre ESTABLISHED goitre and other thyroid enlargements are still prevalent in many parts of the British Isles, particularly in country districts. It is now debatable whether clinical enlargement of the thyroid gland in adolescence should be regarded as wholly physiological or as an over-adaptation to a deficiency ; its incidence is high in goitrous areas where the water contains little iodine and very low in areas with waters of,high iodine content, where adult goitre is rare. Lately the Medical Research Council has published the results of an inquiry1 into the distribution of such conditions and their association with the content of iodine and As a rule other minerals in the drinking-water. surveys of established goitre at all ages are impracticable, since to be reliable they must involve house-tohouse visits. It was found, however, that surveys of adolescents in schools, employing a standard method of recording, are eminently practicable. The incidence of simple hyperplasia may be accepted as an index of the goitre hazard," or as reflecting the adequacy or inadequacy of the available iodine in the drinkingwater of the localities concerned. The M.R.C. report outlines a method for assessing the state of the thyroid gland using simple criteria. Any gland can be placed in one of four categories : (a) invisible -at rest ; (b) visible at rest but soft, smooth, and symmetrical; (c) conspicuously visible but still soft, smooth, and symmetrical; and (d) visible and classified as pathological because the gland is firm, nodular, or asymmetrical, or abnormal in respect of more than one of these characters. With such criteria, a survey has been made covering 1737 children aged 11-15 years in four areas of England served with waters of widely differing iodine content. The generally accepted inverse ratio between the incidence of thyroid enlargement and iodine content of the drinking-water has been confirmed. Similar surveys have also been made covering a wide area of England and some parts of Scotland and including nearly 4000 children aged 11-17 years. The incidence of thyroid enlargement and the iodine content of the water in the areas surveyed have also been considered in relation to the hardness of the water. The incidence of goitre and thyroid enlargement in some areas of England than in Scottish areas with waters of similar iodine content may prove attributable to the greater hardness of the English waters. The report presents fresh evidence showing the geographical association of endemic cretinism and congenital deafmutism with endemic goitre, and discusses the hereditary and environmental factors influencing iodine requirements. There were too few appropriate areas in the British Isles for the relation between endemic goitre and endemic fluorosis to be
higher
investigated. The practical application of these findings is quite simple. As the goitre subcommittee of the M.R.C.2 advocated four years ago, the general use of iodised salt as prophylaxis against thyroid enlargement and goitre is desirable in Great Britain. Already potassium iodide has been added to the vitamin A and D tablets 1.
Thyroid Enlargement and Other Changes Related to the Mineral Content of Drinking Water : with a note on goitre prophylaxis. By M. M. MURRAY, J. A. RYLE, B. W. SIMPSON, and D. C. WILSON.
2.
Medical
Research 9d.
Stationery Office. 1948. Lancet, 1944, i, 107.
Council
Memo.
no.
18.
H.M.
issued by the Ministry of Food for expectant mothers.3 The M.R.C. now recommend the addition of either 1 part of potassium iodide to 100,000 parts of all common salt sold or 1 part to 40,000 parts of all packeted table salt. Until this is effected, practitioners and medical officers of health in all districts where simple (endemic) goitre is common should encourage the regular use, at least by young children and adolescents, of one of the commercial brands of iodised table salt already on the market. It might also be well to include in the routine examination of all schoolchildren the simple method of assessing thyroid enlargement described in this report...
Annotations ANIMALS
IN
THE
LABORATORY
Universities Federation of Aniinal Welfare with Prof. A. N. Worden of Aberystwyth as editor, have collected in a handbook 4 all the information needed by those who use animals for experiment. This is an outstanding book, and one of which British medicine and veterinary science may be very proud. From the foreword to’ the appendix it is characterised by the richest ,smpathy with and understanding of animals ; its last words are : " The writer will not have burned his midnight oil in vain if as a result even one rat the fewer shall be required in some experiment involving discomfort." The first chapter, on the rights of laboratory animals, surveys the past and present laws in Great Britain and elsewhere relating to experiments on animals. In most countries, including the U.S.A., there are no relevant laws ; and our memories of the callousness with which Nazi doctors experimented on human beings make it the more strange to note that Hitler signed a law enjoining the strictest kindness to animals under experiment. In our country, though man-traps were long ago made illegal, painful animal traps are still permitted. The passages in this chapter on the susceptibility of animals to pain should be read by all who undertake animal experiments. There are chapters on the design of animal-houses and control of pests, but the bulk of the work deals with the natural history, diet, breeding habits, and care of the smaller laboratory animals. Dogs, horses, cats, and goats, for example, are excluded, but full references are given to monographs on animals omitted. Those included are a motley and in some cases menacing collection. Hedgehogs," ive are told, are the most disconcerting of all laboratory animals. Their wall of spines cannot be breached even by patience or guile " ; but they may be induced to uncurl by tickling the spines over the rump. The black rat seems to run When I received a the hedgehog a good second : bite," wrote the late Miss Kelway, I considered I had failed "to avoid upsetting its temper. " It fixes its dark eyes upon you while it seems literally to sink its But this article, even in this teeth into your bone." an breathes book, exceptional love of animals ; gentle Miss Kelway gave up .gloves " and never expected to be bitten." The inclusion of the cotton rat and golden hamster are indications otthe wide scope of the modern animal-house. The hamster. may, alas, remain as one of the few perpetuated records of the work of Jerusalem’s Hebrew University, whose buildings, are today a field of war: all living domesticated hamsters derive from THE
(UFAW),
"
"
"
"
3. Ibid, 1946, ii, 778. 4. UFAW Handbook on the Care and Management of Laboratory Animals. Editor: Alastair N. Worden, B.SC., M.R.C.V.S., A.R.I.C., Milford professor and director of research in animal health, University College of Wales, Aberystwyth. London : Baillière. 1947. Pp. 368. 31s. 6d.
Prevention of Goitre ESTABLISHED goitre and other thyroid enlargements are still prevalent in many parts of the British Isles, particularly in country districts. It is now debatable whether clinical enlargement of the thyroid gland in adolescence should be regarded as wholly physiological or as an over-adaptation to a deficiency ; its incidence is high in goitrous areas where the water contains little iodine and very low in areas with waters of,high iodine content, where adult goitre is rare. Lately the Medical Research Council has published the results of an inquiry1 into the distribution of such conditions and their association with the content of iodine and As a rule other minerals in the drinking-water. surveys of established goitre at all ages are impracticable, since to be reliable they must involve house-tohouse visits. It was found, however, that surveys of adolescents in schools, employing a standard method of recording, are eminently practicable. The incidence of simple hyperplasia may be accepted as an index of the goitre hazard," or as reflecting the adequacy or inadequacy of the available iodine in the drinkingwater of the localities concerned. The M.R.C. report outlines a method for assessing the state of the thyroid gland using simple criteria. Any gland can be placed in one of four categories : (a) invisible -at rest ; (b) visible at rest but soft, smooth, and symmetrical; (c) conspicuously visible but still soft, smooth, and symmetrical; and (d) visible and classified as pathological because the gland is firm, nodular, or asymmetrical, or abnormal in respect of more than one of these characters. With such criteria, a survey has been made covering 1737 children aged 11-15 years in four areas of England served with waters of widely differing iodine content. The generally accepted inverse ratio between the incidence of thyroid enlargement and iodine content of the drinking-water has been confirmed. Similar surveys have also been made covering a wide area of England and some parts of Scotland and including nearly 4000 children aged 11-17 years. The incidence of thyroid enlargement and the iodine content of the water in the areas surveyed have also been considered in relation to the hardness of the water. The incidence of goitre and thyroid enlargement in some areas of England than in Scottish areas with waters of similar iodine content may prove attributable to the greater hardness of the English waters. The report presents fresh evidence showing the geographical association of endemic cretinism and congenital deafmutism with endemic goitre, and discusses the hereditary and environmental factors influencing iodine requirements. There were too few appropriate areas in the British Isles for the relation between endemic goitre and endemic fluorosis to be
higher
investigated. The practical application of these findings is quite simple. As the goitre subcommittee of the M.R.C.2 advocated four years ago, the general use of iodised salt as prophylaxis against thyroid enlargement and goitre is desirable in Great Britain. Already potassium iodide has been added to the vitamin A and D tablets 1.
Thyroid Enlargement and Other Changes Related to the Mineral Content of Drinking Water : with a note on goitre prophylaxis. By M. M. MURRAY, J. A. RYLE, B. W. SIMPSON, and D. C. WILSON.
2.
Medical
Research 9d.
Stationery Office. 1948. Lancet, 1944, i, 107.
Council
Memo.
no.
18.
H.M.
issued by the Ministry of Food for expectant mothers.3 The M.R.C. now recommend the addition of either 1 part of potassium iodide to 100,000 parts of all common salt sold or 1 part to 40,000 parts of all packeted table salt. Until this is effected, practitioners and medical officers of health in all districts where simple (endemic) goitre is common should encourage the regular use, at least by young children and adolescents, of one of the commercial brands of iodised table salt already on the market. It might also be well to include in the routine examination of all schoolchildren the simple method of assessing thyroid enlargement described in this report...
Annotations ANIMALS
IN
THE
LABORATORY
Universities Federation of Aniinal Welfare with Prof. A. N. Worden of Aberystwyth as editor, have collected in a handbook 4 all the information needed by those who use animals for experiment. This is an outstanding book, and one of which British medicine and veterinary science may be very proud. From the foreword to’ the appendix it is characterised by the richest ,smpathy with and understanding of animals ; its last words are : " The writer will not have burned his midnight oil in vain if as a result even one rat the fewer shall be required in some experiment involving discomfort." The first chapter, on the rights of laboratory animals, surveys the past and present laws in Great Britain and elsewhere relating to experiments on animals. In most countries, including the U.S.A., there are no relevant laws ; and our memories of the callousness with which Nazi doctors experimented on human beings make it the more strange to note that Hitler signed a law enjoining the strictest kindness to animals under experiment. In our country, though man-traps were long ago made illegal, painful animal traps are still permitted. The passages in this chapter on the susceptibility of animals to pain should be read by all who undertake animal experiments. There are chapters on the design of animal-houses and control of pests, but the bulk of the work deals with the natural history, diet, breeding habits, and care of the smaller laboratory animals. Dogs, horses, cats, and goats, for example, are excluded, but full references are given to monographs on animals omitted. Those included are a motley and in some cases menacing collection. Hedgehogs," ive are told, are the most disconcerting of all laboratory animals. Their wall of spines cannot be breached even by patience or guile " ; but they may be induced to uncurl by tickling the spines over the rump. The black rat seems to run When I received a the hedgehog a good second : bite," wrote the late Miss Kelway, I considered I had failed "to avoid upsetting its temper. " It fixes its dark eyes upon you while it seems literally to sink its But this article, even in this teeth into your bone." an breathes book, exceptional love of animals ; gentle Miss Kelway gave up .gloves " and never expected to be bitten." The inclusion of the cotton rat and golden hamster are indications otthe wide scope of the modern animal-house. The hamster. may, alas, remain as one of the few perpetuated records of the work of Jerusalem’s Hebrew University, whose buildings, are today a field of war: all living domesticated hamsters derive from THE
(UFAW),
"
"
"
"
3. Ibid, 1946, ii, 778. 4. UFAW Handbook on the Care and Management of Laboratory Animals. Editor: Alastair N. Worden, B.SC., M.R.C.V.S., A.R.I.C., Milford professor and director of research in animal health, University College of Wales, Aberystwyth. London : Baillière. 1947. Pp. 368. 31s. 6d.