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The Ecology of Endemic Goiter^*

The most prominent clinical manifestation of iodine deficiency is goiter, a disease which has widespread prevalence throughout the Pacific area. In the countries to the east from Alaska to the southern tip of Chile, in those areas which border the western shores, as well as in Australia, New Zealand and the many islands of the Pacific, goiter has been or continues to be a serious problem. Such thyroid enlargement is generally related to the content and circulation of iodine in the lithosphere, hydrosphere, and atmosphere, and in the edible plants and animals derived from these environments. Hence, endemic goiter becomes a problem in medical ecology, that is, the reaction of the host, man, to an environment which is deficient in iodine. Endemic goiter provides an example of the simplest type of host-environment relationship, for in its analysis one is not concerned with such factors as animate agents, definitive hosts, or intermediate reservoirs, all of which make the ecology of diseases produced by living agents so complex.

^* Presented as a part of a Symposium on Medical Ecology at the Tenth Pacific Science Congress, Honolulu, September 1, 1961.