[The history of science with regard to the thyroid gland (1800-1960)]

This review describes the changing medical perspectives from 1800 to 1960 with regard to the thyroid gland. During the XIXth century, clinical medicine identified the different thyroid diseases: goitrous cretinism (1802), Graves disease (1835-1856) and myxedema (acquired or post-surgery 1888). These clinical entities facilitated the construction of the first complete schema of endocrinology: one gland, one internal secretion and one replacement therapy with an organ extract. With the emergence of biochemistry at the beginning of the XXth century, the first thyroid hormone--thyroxin--was identified. Alternative medical treatments aimed at blocking thyroid secretion, were proposed in 1940 leading to the use of radioiodine and antithyroid compounds which were also used in physiological studies. From 1940 to 1970, the application of radioiodine shed a completely new light on thyroid physiopathology. The main transformations brought about by this tool were the knowledge of radioiodine uptake mechanisms, basis of its therapeutic effect, complete identification of thyroid hormonosynthesis, serum transport of thyroid hormones and thyroid imaging. More recently immunological and molecular paradigms changed the understanding of thyroid diseases. In spite of novel definitions, there was no therapeutic revolution like those introduced by iodine treatment (1820) thyroid surgery (1880), thyroid extract (1893) radioiodine and antithyroid drugs (1940), underlining the actual therapeutic stagnation.

The prevalence of sub-clinical thyroid dysfunction was 8%. No male subject was affected. The prevalence of nodule was close to 15%. Contrary to the literature, we have not found high incidence of immunological abnormalities in this old population.