Prolonged Treatment of Exophthalmic Goiter by Iodine Alone

The value of a short intensive course of iodine medication as a method of preparing a patient with exophthalmic goiter for thyroidectomy has been unquestioned since the report of Plummer¹in 1923. Following his announcement, the use of iodine in this disease rapidly became widespread. It was soon noted by various observers, beginning with Starr, Segall and Means,²that in cases in which this medication was prolonged, its effect, though striking, was usually only temporary; and that after a few weeks the patient might be as ill as before it was started, if not worse. Thus, in general, the prolonged treatment for exophthalmic goiter with iodine alone has come to be regarded as a futile, if not a dangerous, procedure. There are, however, some observations in the literature concerning favorable results in exophthalmic goiter with this method of treatment. Trousseau,³in 1863, mentioned a patient in whom the disease was