Thyroid Surgery 1872 – The 1909 Nobel Prize in Physiology

In 1886, regarding goiter, a condition that enlarges the thyroid gland, the American surgeon Samuel Gross wrote in his notes about the difficulties of removing the swollen gland:

“A sensible man would not attempt to remove a goitrous thyroid gland. If a surgeon is so bold or rash, he will spill blood with every stroke of his knife, and should count himself lucky if his victim survives until he finishes his terrible slaughter.”

Goiter results from a deficiency of iodine, which helps the thyroid gland synthesize the hormones needed for metabolism and growth. Modern successful thyroid surgery began with the Swiss surgeon Emil Theodor Kocher, who performed thousands of operations from 1872 onward. Kocher won the Nobel Prize for his work on the physiology, pathology and surgery of the thyroid gland.

Unfortunately, although people can live for years without a thyroid, the lack of thyroid hormones ultimately causes mental and physical disorders. Kocher said,“I condemned people with goiter to a vegetative existence, turned [many of them] into creatinine, and saved them to live a life not worth living.”

The thyroid gland, located in the neck, has two lobes resembling a butterfly's wings. Its two main hormones are triiodothyronine and thyroxine. 

• Hyperthyroidism is a disorder in which these hormones are overproduced, with symptoms such as weight loss, a rapid heartbeat and weakness. 
• Hypothyroidism means insufficient hormone production, with symptoms such as fatigue, constipation and hair loss. 

Fortunately, hyperthyroidism can be treated in various ways, including radioactive iodine, which accumulates in the thyroid gland and can destroy all or part of it. Following this treatment, a person may show symptoms of hypothyroidism, but these can be treated with daily tablets containing synthetic thyroxine. 

When thyroid hormone levels are low, the hypothalamus in the brain releases a hormone (TRH) to prompt thyrotropin release, causing the pituitary gland to secrete thyroid-stimulating hormone (TSH). This stimulates thyroid hormone production. Conversely, when thyroid hormone levels are high, TRH and TSH production is suppressed.

About the Article Image: A Swiss woman operated on by Emil Theodor Kocher

Historical Figures Mentioned in the Article: Samuel David Gross (1805–1884), Emil Theodor Kocher (1841– 1917)

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