,, ‘L’ I am certified by the American no longez desirable. ~~~rds of Internal Medicine, and am a Fellow of thie American I am registered in the Occupational Medical Association. states of California, Texas, and Illinois to practice rriedicir,e . Finally, as part of my internal medical training, I did one year of intensive pathology. I was immediately struck by Now for my observation: the remarkable frequency of visual difficulties and the The frequency of thyroid frequency of thyroid tumors. tumors was sho’~n by the examination of a nuvber of. patients. who demonstrated thyroidectomy scars; by the examlna~lon hospital record, and most importai]t by the history of SOiT,e of the people telling me of the epidemic of these disorders Since the populations on the islands on their islands. varied from two hundred to more, often, particularly in the smaller islands, the individuals who spoke to me wk,ere a’ble to give me a pretty fair idea of the number of thyroid tumors and visual difficulties that appeared on their island. .4 .2: .7 ,.:.: i .: . . .> + .. Since the nuclear explosions there has been a rer,arkable epidemic of thyroid ~umors in the Marshall Islands, -to my kno;+ledge a singular epidemic since I have ne-$er seen its like before, -- starting about fifteen yezrs or so after the onset of the atomic explosions,.and contiSome of the victims apparently nuing to the present. were in their teens or pre-teens during the explosions and were most characteristically female but some of the victims ~<ere probably not yet born at the time of the explosion, although I do not have such a conci”se chronology that I can say this with absolute certainty. I recall seeing one patient young enough so that it would be hardly likely that she would have been born during the explosions. The thyroidectomy scars that I saw on these patients were large scars, and for the most part it seems to me This was borne that the entire thyroid had been removed. . -2-