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2008 Zimmermann Research On Iodine Deficiency and Goiter in The 19th and Early 20th Centuries J Nutr
2008 Zimmermann Research On Iodine Deficiency and Goiter in The 19th and Early 20th Centuries J Nutr
History of Nutrition
The Human Nutrition Laboratory, Swiss Federal Institute of Technology, 8092 Zürich, Switzerland and the Division of Human
Nutrition, Wageningen University, 6700 Wageningen, The Netherlands
Abstract
In 1811, Courtois noted a violet vapor arising from burning seaweed ash and Gay-Lussac subsequently identified the vapor
as iodine, a new element. The Swiss physician Coindet, in 1813, hypothesized the traditional treatment of goiter with
seaweed was effective because of its iodine content and successfully treated goitrous patients with iodine. Two decades
I am satisfied. I have seen the principal features of dried seaweed to treat goiter. In the 13th century, de Villanova
Swiss scenery —Mount Blanc and the goiter— and now (1) cautioned the effect of the sponge on goiter was limited: it
for home. could cure goiter of recent origin in young people but had only a
modest effect on large, chronic goiters. The sponge remained a
Mark Twain, 1880 Ôgoiter cureÕ in the medical armamentarium through the Middle
Ages and into the modern era, but it was not until 1819 that
Straub demonstrated sponges are rich in iodine. In 1813, learning
Introduction
of the discovery of iodine in seaweed, Coindet (2,3), a physician
In 1811, France was at war, and Bernard Courtois was producing in Geneva, Switzerland, hypothesized the traditional treatment
saltpeter for gunpowder for Napoleon’s army. He was burning of goiter with seaweed or sponges was effective because of their
seaweed to isolate sodium bicarbonate and when he added sulfuric iodine content. He began giving oral iodine tincture to goitrous
acid to the ash, he produced an intense violet vapor that crys- patients at an initial daily dose at 165 mg, with a gradual dou-
tallized on cold surfaces. He sent the crystals to Gay-Lussac (1), bling of the dose. This provoked strong opposition among the
who subsequently identified it as a new element and named it medical profession; opponents claimed it was poisonous and it
iodine, from the Greek for violet. Iodine (atomic weight 126.9 was suggested ‘‘.Coindet would not leave his house for fear of
g/atom) is an essential component of the hormones produced by being stoned in the street by his poisoned patients..’’ Although
the thyroid gland and is therefore essential for mammalian life. Coindet (2,3) insisted his treatment was safe when carefully
The ancient Greeks, including Galen, used the marine sponge administered, the often acrimonious debate on the safety of
to treat swollen glands, but Italian physicians of the School of iodine would continue into the early 20th century, particularly in
Salerno were the first to report the specific use of the sponge and central Europe.
2062 Zimmermann
similar to those recommended a century earlier by Coindet (2). 3. Coindet JF. Nouvelles recherches sur les effets de l’iode et sur les
The results were unequivocal: in the over 1200 girls in the un- précautions à suivre dans le traitement du goı̂tre par ce nouveau remède.
Ann Chim Phys. 1821;16 (Ser. 2):345–56.
treated group at baseline, .25% had goiter at their final
4. Boussingault JB. Recherches sur la cause qui produit le goı̂tre dans les
examination. In the 900 girls who received iodine who were not Cordilieres de la Nouvelle-Grenade. Ann Chim Phys. 1833;48:41–69.
goitrous at baseline, only 0.2% showed evidence of enlarge- 5. Chatin A. Recherches sur l’iode des eaux douces; de la présence de ce
ment. Marine and Kimball concluded that goiter ‘‘.is as easily corps dans les plantes at les animaux terrestes. C R Acad Sci Paris.
prevented in man as in fish or in domestic animals’’ (27). Based 1851;31:280–3.
on these and other successful experiments, general prophylaxis 6. Bussy M. Rapport sur les travaux de MM. Chatin, Marchand, Niepce,
with iodized salt was introduced in the state of Michigan in Meyrac, relatifs à la recherche de l’iode. C R Acad Sci Paris. 1852;
1924. Based on an estimated per capita salt intake of 6.5 g/d, 35:505–17.
100 mg/kg potassium iodide was added to table salt to provide 7. Hirsch A. Handbook of historical and geographical pathology. London:
New Sydenham Society; 1985.
500 mg/d. There were protests and at first the Bureau of
8. Ord W. Clinical lecture on myxoedema. BMJ. 1878;i:671–2.
Chemistry of the USDA demanded the iodized salt packages be
9. Semon F. Discussion on myxoedema. BMJ. 1883;ii:1072–3.
marked with the skull and crossbones used to indicate a poison
10. Kocher T. Concerning pathological manifestations in low-grade thyroid
but then backed down. In Cleveland, Ohio, many households diseases. In: Nobel lectures, physiology or medicine, 1901–1921.
did not adopt iodized salt, and a study in 1936 found 31% of Amsterdam: Elsevier; 1909. p. 330–83.
children not receiving iodized salt were goitrous, compared with 11. Beadles CF. The treatment of myxoedema and cretinism, being a review
7% of children using iodized salt (28). In 1948, the U.S. Endemic of the treatment of these diseases with the thyroid gland, with a table of
Goiter Committee tried to introduce iodized salt to all the states 100 published cases. J Ment Sci. 1893;39:343–55.
by federal law, but the bill failed. 12. Baumann F. Ueber das normale Vorkommen von Jod im Thierkörper. Z
Phys Chem. 1896;21:319–30.