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October 18, 1947


JAMA. 1947;135(7):434-435. doi:10.1001/jama.1947.02890070036011

Before modern processes for refining salt were developed, most table salt contained iodine, a natural contaminant. In regions where such salt was consumed colloid goiter was uncommon. Modern table salt is recrystallized by heating to high temperatures; any iodides contained are decomposed by these high temperatures and the iodine is lost. In the Kanawa River Valley in West Virginia salt obtained from local mines has a content of iodide representing roughly 80 parts of iodine for each million parts of salt. In the 1890s salt refined by modern methods replaced this natural product. The whiteness of the new salt together with its pouring qualities quickly overcame such competition as could be offered by the local product. Substitution of the whiter, better-pouring salt for the local product soon was followed by the appearance in this valley, apparently for the first time, of colloid goiter. The number of cases of goiter rapidly

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