THYROTOXICOSIS COMPLICATED BY SEVERE IODISM: PREPARATION FOR SURGERY WITH PROPYL-THIOURACIL

AS commonly used in the preoperative management of thyrotoxicosis, Lugol's solution is generally considered to have no harmful potentialities. Few instances of severe toxic reactions to this drug are reported in the literature. With the exception of two cases in a series reported by Barker and Wood (3) in 1940, all the reported episodes were mild to moderate in degree. As further evidence that Lugol's solution even in small doses may, on occasion, be a dangerously toxic drug, a case of almost fatal poisoning is here presented. Case Report: H.B., a negress, age 22, was admitted to the medical service on May 4, 1946, with the classical complaints of hyperthyroidism. Her symptoms were nervousness, insomnia, marked fatigability and irritability, loss of weight despite an excellent appe-tite, intermittent diarrhea, and intolerance to heat with excessive perspiration. She had noted a mass in the neck, gradually increasing in size, associated with some difficulty in swallowing, and shortness of breath after mild exercise. In addition, her menses, which had been regular since their onset at the age of thirteen, had become markedly irregular in the past two years.