On the etiology of endemic goitre: with special reference to the urban district of Heanor in the county of Derby

Endemic Goitre is a disease, the etiology of which has not yet reached any finality. Indeed there is scarcely any subject within the ever-increasing domains of medicine, whereof we may say that final and and conclusive opinions have been reached: of many things we know much, of others little; and of those things in wnich we pride ourselves with overweening vanity, our knowledge frequently amounts to little, ilerfection is not of this world.The etiology of this disease,which, in this country has for one of its best known habitats, the County of Derbyshire, and which has received the name of "Derbyshire heck", has exercised in my mind an absorb‘ing and increasing interest. The question is intimately associated with the physiology and pathology of the thyroid gland. A study of the' literature of the internal secretions leaves one almost dazed. The outpouring of papers on disorders of the thyroid gland itself is enormous, year by year, as a casual perusal of the Index Medicus will show, Biedl’s Internal Secretion contains a huge number of references - as does L. F. Baker's Endocrinology. If one were to make a close study of all the literature on the subject of Endemic Goitre alone I fear one would do nothing else. Life would be too short - Forcibly indeed is the truth of the Latin Quip brought home, "Ars longa, vita brevis." From the days of Hippocrates to the present time the subject has had its champions, numerous as an army with almost as many theories of the essential cause. Nevertheless there are certain facts emphasised by our forefathers which remain true and unshaken to the present day