out both by palpation of the glands of some of these people, and also their dose of thyroid replacement drugs. Since. some who had run out of thyroid replacement mediCation clinically appeared thryroprivic therefore I feel usually the entire thyroid was removed, a type of surgery commonly performed for thyroid cancer and not a simple benicn adenoma. However I] understand from several sources that the Brookhaven Institute under the name of Dr. Conard and his associates reports that in the Marshall Islanders there are only very few cancers of the thyroid found, but that almost all of the lesions of the thyroid were benign adenomas. This creates a conflict in my mind, since of the patients, perhaps eighteen to twenty, who had demon- strated to me thyroid scars, one of them was identified histologically as a papillary edenocarcinoma of the thyroid, (in Guam) and this in a relatively young man; and in case of he presented an unduly hard nodule un the lower portion of one of the thyroid lobes, -- so hard, and so well set apart from the thyroid tissue itself, that I fear this also might be a carcinoma. That radiation culd produce so many benign adenomas and so relatively few carcinomas as I am led indirectly to believe is difficult for me to accept. I should, vere I involved in further study, like to see secticns of all the thyroids removed. One should know that there readily arises an honest difference of opini on thet occurs between patholoGists as to what constitutes malignancy in thyroid tunors anc microsccpic re-evaluation will be useful. A second opinion based on microscopic re-evaluation of the tissue is Justified by the very high incicence of benign tumors compared with malignant tumors, ffects in face of the known of radiation in producing malignancy. There appears to be little Coubt that the tumors, benign or malignant, are radiaticn-induced. There are just too many of them to be anvthing else. Otherwise one would have to postulate that the Marshallese had a remarkably high incid@ence racially of tumors of the thyroid, this existing before 1946, end the old people I] spoke to Genied this. They denied that prior to the bombs there was any particular epidemic of lumps in the neck. I cannot therefore accept the belief that the Marshall Islanders simply by virtue of their heredity have a tengency toward thyroid tumors. The other thing that struck me was the frequency of se AA yes he epee FRC Yas lh MATEO AL ALY one)