It is quite generally agreed, although with some dissatisfaction, that the thyroid gland is responsible, when abnormally active, for the symptoms that characterize exophthalmic goiter. A vast literature has accumulated on this subject, with the majority of writers and investigators favoring the thyrogenic origin of the disease. A few have taken exception to this view; the most notable among these being McCarrison, who for many years has stoutly maintained that the disease is of toxic origin, and that the toxin or toxins originate in the intestinal tract. Plummer,1 who favors the thyrogenic theory, described the disease as one in which the symptoms are due to dysfunction of the thyroid, excess thyroxine as well as an abnormal substance being present. McCarrison,2 however, stated that "in the vast majority of cases the excitation which determines the gland's derangement is toxic, and is one which initiates disturbances of the whole endocrine
REVENO WS. THE CAUSE OF EXOPHTHALMIC GOITER: A BIOCHEMICAL HYPOTHESIS. Arch Intern Med (Chic). 1931;48(4):592–597. doi:10.1001/archinte.1931.00150040058004
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