The Heritage of Dr. Hakaru Hashimoto (1881-1934)

摘要

Goiter of one type or another has been a problem for centuries. Often associated with iodine deficiency in mountainous areas, such as Switzerland, some goiters were quite disfiguring. Eventually, by the end of the 19th century, surgeons perfected the operative cure of this disorder, later followed by the possibility of its prevention by supplying sufficient iodine. However, some goiters seem not to be related to iodine deficiency. One of these is the disease extensively described by Hakaru Hashimoto in 1912. Hashimoto, then finishing his surgical training at Fukuoka, wrote an article that established his name as the eponym for goitrous lymphocytic thyroiditis, an entity that many years later was realized to be an autoimmune disease of the thyroid gland. Hashimoto's article, entitled, "Notes on lymphomatous in the thyroid gland (struma lymphomatosa)" was essentially a monograph; he wrote in German in a German journal because that was the scientific language of the time and he probably thought that writing in German would make his work more available around the world. Curiously, as his career led not to academia but to the practice of medicine in his home town, this article was his only publication on the thyroid gland. To define Hashimoto's heritage, this paper first describes what Hashimoto found and then shows the effect of Hashimoto's description on others' subsequent thinking about thyroid disease over the following ninety years.