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December 21, 1970

Antithyroid-Thyroid Therapy for Thyrotoxicosis

JAMA. 1970;214(12):2198. doi:10.1001/jama.1970.03180120070027

To the Editor.—  In a recent THERAPEUTIC GRAND ROUNDS (213:1652, 1970), Dr. William Green, the discussant in an exercise entitled "Management of Juvenile Hyperthyroidism," alludes to combined use of an antithyroid drug and thyroid replacement for therapy for this disorder. Dr. Green cites the Billings' Lecture delivered by Dr. John Eager Howard (202:706-709, 1967) as a supporting reference. With due deference to Dr. Howard's serendipitous discovery of antithyroid-thyroid therapy for thyrotoxicosis, scientific credits for introducing this approach to therapy should be clarified. Fraser and Wilkinson (Brit Med J1:481-484, 1953) were, to my knowledge, the first to publish objective clinical data on the use of thyroid hormones together with antithyroid drugs. These investigators surely deserve the primary citation. Their report reviewed animal research supporting the physiologic basis for this usage and referred to other investigators who had previously recommended combined therapy. Their findings were substantiated later by Bergfelt