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December 13, 1924


JAMA. 1924;83(24):1938-1939. doi:10.1001/jama.1924.02660240052025

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The Goiter Problem  At the convention of German scientists, Wegelin of Bern discussed the pathologic aspects of goiter. The endemic occurrence of goiter in various countries must not be regarded, without investigation, as identically the same manifestation, for goiter presents many different anatomico-pathologic aspects. Wegelin confined himself to the goiter of the Alpine countries. The enlargement of the thyroid gland, found almost universally in the inhabitants of the endemic regions, cannot be differentiated from goiter; it is, in fact, the foundation on which the clinically protruding goiters develop. Histologically, the goiter of the Alpine countries is, in its beginnings, always an epithelial hyperplasia, which in Bern is manifested even in the fetus and leads to struma congenita. This consists of firm cellular columns, simple and branched tubular glands and small, for the most part colloid-free spaces. In contrast with the iodin-containing thyroid gland of the new-born in nongoitrous countries, the

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