The History of the Thyroid Gland

Historical references to what we now know as the thyroid gland arise early in medical history. In 1600 BC the Chinese were using burnt sponge and seaweed for the treatment of goitres (enlarged thyroid glands). Celsus first described a bronchoceole (a tumour of the neck) in 15 AD. Around this time Pliny referred to epidemics of goitre in the Alps and also mentioned the use of burnt seaweed in their treatment, in the same way as the Chinese had done 1600 years earlier. In 150 AD Galen, an instrumental figure in the transition from ancient to modern medicine, referred to 'spongia usta' (burnt sponge) for the treatment of goitre. He also suggested (incorrectly, as it turns out) that the role of the thyroid was to lubricate the larynx.

In 650 AD, Sun Ssu-Mo used a combination of seaweed, dried powdered mollusc shells and chopped up thyroid gland for the treatment of goitre. Ali-ibn-Abbas was the first to discuss surgery as a treatment for goitres in 990 AD. Jurjani's 'Treasure of Medicine' in 1110 AD first associated exophthalmus, the protrusion of the eyes we now associate with Graves' disease, with goitre.

It was not until 1475 that Wang Hei anatomically described the thyroid gland and recommended that the treatment of goitre should be dried thyroid. Paracelsus, some fifty years later, attributed goitre to mineral impurities in the water. Finally, In 1656 Thomas Wharton named the gland the thyroid, meaning shield, as its shape resembled the shields commonly used in Ancient Greece.

In 1811, Paris discovered iodine in the burnt ashes of seaweed and the idea that this was the active ingredient in the treatments that were prescribed for goitre developed. Ten years later Prout was the first to recommend iodine in the treatment of goitre. In 1835, Graves published his accounts on exophthalmic goitre. Ord first described myxoedema in1878. Rehn carried out the first thyroidectomy (removal of the thyroid gland) for exophthalmic goitre in 1880.

 Theodor Kocher demonstrated that total thyroidectomy caused hypothyroidism but thought that the symptoms were due to chronic air way obstruction, it was not until 1888 that it was realised that the cause of the symptoms was the lack of thyroid.Recommended treatment was "half a sheep's thyroid lightly fried and taken with current jelly once a week". Kocher was awarded the Nobel Prize for Medicine in 1909.Kocher was one of greatest surgeons of his era,he was born ar Berne in 1841 and died during the first world war in 1917.The majority of his professional life was spent in the surgical clinic in Berne where he was finally head of department

Theodor Kocher  1841-1917

The idea that the thyroid produced an iodine containing substance was investigated in the last century, and Kendall in 1914 isolated an iodine-containing substance from thyroid tissue.  By 1920 thyroid surgery was commonplace and the great American surgeon William Halstead referred to the operation of thyroidectomy as a "feat which today can be accomplished by any competent operator without danger of mishap". This statement is true today only if the surgeon specialises in thyroid surgery. It was not until some 20 years later that Pitt-Rivers and Harrington determined the structure of the first thyroid hormone to be recognised.