An invaluable adjunct in the pre-operative preparation of patients with Graves’ Disease, Lugol’s iodine markedly reduces both the size and vascularity of the gland – however that was not the intent of its creator. Jean Guillaume Auguste Lugol was born in 1786 at Montauban, France. He graduated MD Paris in 1812 and seven years later was appointed to the staff of the Hopital St Louis. His great interest in life was scrofula, a collective term applied to tuberculous lymph nodes, tuberculous bones , and tuberculous joints before it was known that these conditions were caused by the same organism that caused pulmonary tuberculosis.
At the IAES Meeting in Durban in August, Jon van Heerden presented the story of Mother Joachim, the first successfully removed phaeochromocytoma in the US. Whilst a number of such tumours had been previously removed in Europe, the accurate recording and astute observations make a fascinating story.
Cecil Joll devoted an entire chapter of his historic book to non resectional surgical treatment of thyrotoxicosis. The following are selected extracts.
“Exopthalmic goitre” widely known as Graves’ Disease in the English-speaking world was actually first noted by Caleb Hiller Parry in 1786. It was not until 1825 however that his account of eight patients with “enlargement of the thyroid gland in connexion with palpitation of the heart” was published posthumously. In 1835 Robert Graves described three patients with “a newly observed affectation of the thyroid gland in females”, noting palpitations, thyroid enlargement and exophthalmos.
Countless articles and references describe the first recognised successful parathyroidectomy performed by Felix Mandl in 1925 on a Viennese streetcar conductor with osteitis fibrosa cystica. However that procedure may not have been the first successful removal of a parathyroid tumour associated with symptoms of hyperparathyroidism The following extract from Sir John Bland-Sutton’s 1917 textbook of pathology, “Tumours Innocent and Malignant” demonstrates that the first successful parathyroidectomy may well have unwittingly preceded any knowledge of the condition of hyperparathyroidism. “An enormous literature has grown up around the parathyroids. Some surgeons are of the opinion that the importance attached to these minute bodies is exaggerated.