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June 5, 1915


Author Affiliations

Fellow of the American College of Surgeons ST. LOUIS

JAMA. 1915;LXIV(23):1896-1898. doi:10.1001/jama.1915.02570490012005

If, in the present state of our knowledge of the clinical manifestations of goiter, we undertake to operate on others than those that are unquestionably causing immediately grave, evidently correlated detriment, a very nice discrimination must be exercised. In young people it is probable that most of the enlargements are more or less physiologic, an effort to meet an increased demand; here if any treatment is indicated it certainly should not be of a destructive kind.

The real or fancied presence of a goiter is rather common. Even more common are individuals who are out in their functional adjustment; the neurasthenic, the highly strung person suffering from mental or physical overstrain, the early phthisic, or the patient suffering from any one of a number of chronic intoxications; many of these give a picture that may more or less closely resemble thyroid intoxication or irritation, and these individuals may have a

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