Aside from all question of the exciting cause, the immediate source of the clinical syndrome called exophthalmic goiter lies entirely within the thyroid gland. Tomorrow we may be able to reach the activating agent; today we must reach the activated gland itself. Its removal is incompatible with the continued existence of the disease in its various forms. Nowhere in medicine is more inexplicable sophistry displayed than in the discussion of this subject. To state that such a percentage of patients are cured by thyroidectomy evidences a total failure to grasp the relation of the thyroid gland to the disease and of thyroidectomy to its cure. A prophylactic inoculation that fails to prevent smallpox does not lead to any discussion of the preventive value of vaccinia. The presence of smallpox is evidence that vaccinia was not produced, whatever may have been the local reaction following the attempted vaccination. The failure of
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H Richter (1927) studied this question.
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