Soon after the treatment for exophthalmic goiter with iodine became general, it was recognized that during prolonged administration the basal metabolism often rose markedly after an initial drop, in association with an increase in the severity of the disease. Nevertheless, the impression has prevailed that as long as iodine is being given in excess the peculiar nervous manifestations of exophthalmic goiter are completely under control, regardless of what happens to the rate of the basal metabolism.1 Certain observations that we have made suggest that this may not always be the case.
During the continuous administration of iodine in the following case, the patient, after initially showing a marked response to the administration of about 6 mg. (1 drop of the compound solution2) daily, slowly became completely refractory to this dose, both from the standpoint of basal metabolism and from that of signs and symptoms. Exophthalmos first appeared as