Reports of the frequency of occurrence of thyroid enlargement have been made in considerable numbers, but they have come largely from areas included in the so-called goiter belt. As far as can be ascertained, no figures from Tennessee have been published and not many figures have come from southern states.
Rutherford County, Tenn., is a fairly typical agricultural county situated in the geographic center of the state. McCarrison 1 has said that the ideal conditions for a goitrous region are a "country district, inhabited by agricultural people, living on porous soil, in the presence of abundant organic material." Even if the last requirement is discounted, Rutherford County meets the condition well; though outside the boundaries of the "goiter belt," it is not distant from the borders of that area where simple goiter is endemic. The hilly formation of the county is almost wholly of limestone. It has been observed 2
MUSTARD HS, WARING JI. THYROID ENLARGEMENTOCCURRENCE IN SCHOOL CHILDREN IN RUTHERFORD COUNTY, TENNESSEE. JAMA. 1927;88(10):714–716. doi:10.1001/jama.1927.02680360026009