VIII.61 - Goiter

Summary

Quis tumidum guttur miratur in Alpibus?

Juvenal, Satire 13, c. A.D. 127

Goiter is an ancient disease that has always been more common in some places than in others. Chinese writings show that goiter was known at least by the third century B.C. (Lee 1941) and possibly earlier (Needham et al. 1970). When Juvenal (Decimus Junius Juvenalis), the Roman satirist, wrote, about A.D. 127, “Who is amazed at a swollen neck in the Alps?” he knew that goiter was so much more common there than elsewhere that it should be no surprise.

Terminology

The word “goiter” (or goitre in Europe) derives from the Latin gutter, but the meaning has shifted from “throat” or “neck” to mean specifically an enlarged thyroid gland. An ancient Greek synonym was bronchocele, a term actually used to describe any enlargement in the neck, although it meant literally a swelling or an outpouching of the trachea. Over time this term also came to mean an enlarged thyroid (e.g., the English “bronchocele” of the eighteenth and nineteenth centuries). Modern synonyms are the Spanish bocio (from Latin, botium), the Italian gozzo, and the German Kropf. The ancient Latin word struma was probably originally used to describe inflamed lymph nodes in the neck, most likely tuberculous, but was later used to denote the normal thyroid gland, and is still so used although it is almost obsolete.

Confusion over names is understandable, as the thyroid gland itself was unknown until the sixteenth century. Leonardo da Vinci may have drawn the thyroid about the year 1500, but the drawing was not published until much later. Andreas Vesalius did note “laryngeal glands” in 1543, but not in humans.