Psychic Trauma in Pathogenesis of Exophthalmic Goiter*

The taking of a careful history in patients with exophthalmic goiter commonly yields three important facts: (1) Information to the effect that one or more blood relatives is or had been suffering with “nervousness,” exophthalmic goiter, or diabetes mellitus; (2) the patient has been of more or less “nervous” temperament, characterized by irritability, impatience, fractiousness, and emotionalism, usually since childhood; (3) the onset of the symptoms of the disease followed soon after the occurrence of a psychic trauma. From the frequency with which such histories are elicited,it appears that there is a strong congenital predisposition to the disease. Indeed, in quite a series of the cases herein reported, two, three, and even four members of a family have been afflicted with exophthalmic goiter. In the absence of an exciting cause, such a predisposition may not be recognizable nor tangibly mar the individual’s physical and mental well-being throughout a normal span of existence. There are doubtless many thousands of individuals possessing a strong susceptibility to exophthalmic goiter who are going through life in an apparently normal manner, oblivious to possibilities which would likely follow the incidence of a psychic trauma.