RADIOIODINE AND THE TREATMENT OF HYPERTHYROIDISM - THE EARLY HISTORY

Little was known about iodine metabolism in the mid-1930s, but when Sa ul Hertz and his chief, J. Howard Means, at the Massachusetts General Hospital (MGH) realized in 1936 that radioiodine could be made and use d as a tracer, they arranged with physicists Robley Evans and Arthur R oberts at the Massachusetts Institute of Technology (MIT) to make the short-lived I-128 and study its physiology in rabbits. By 1938, they s howed that the rabbit's thyroid gland rapidly took up I-128, especiall y when there was only a little non-radioactive iodine present. There w as, however, no hope of using I-128 as a treatment because of its brie f half-life (25 minutes). In 1939, Joseph Hamilton and Mayo Soley, wor king with Ernest Lawrence's cyclotron in Berkeley, California, were ab le to make several other radioiodines; one was I-130 (12-hour half-lif e) and another I-131 (8-day half-life). They were the first to give th ese radioiodines to humans to study iodine physiology. The MGH-MIT gro up also built a cyclotron and by 1940 had generated these two new radi oiodines. One of the goals of both groups was the treatment of hyperth yroidism. Hertz and Roberts were the first to do so on March 31, 1941; Hamilton and John Lawrence, Ernest's brother, began on October 12, 19 41. By 1942, the United States was actively fighting in World War II. That Fear both the Boston and Berkeley groups gave preliminary data on the treatment of hyperthyroidism in Atlantic City; both showed that i t was effective and went on to treat more patients. In Berkeley the th erapy was viewed cautiously, and, in any case, the physicists were mai nly occupied with work for the Manhattan District. In Boston Hertz use d the therapy as often as he could, emphasizing the use of I-130, unti l he joined the U.S. Navy in 1943. Earle Chapman, a clinician on the v oluntary staff of the MGH, took over Hertz's practice in 1943; their l ater differences over the precise treatment and who was in charge led to their falling out. After Hertz's release from the Navy he was not p ermitted to return to the MGH and became quite bitter; Chapman stayed on at the MGH. After the war was over, both had acquired a sufficient number of patients--there was then no such thing as a controlled trial --and wrote up the results for publication. Each wrote with a differen t physicist, Hertz with Roberts and Chapman with Evans. When Hertz lea rned that Chapman's paper was being considered by the Journal of the A merican Medical Associations, he quickly sent his manuscript to JAMA a s well. Although the editor of JAMA was puzzled by two papers on the s ame topic from the same institution, both papers appeared in the same issue of JAMA on May 11, 1964, and announced the new therapy as effect ive treatment for hyperthyroidism.