The author had the unique experience of studying these diseases at first contact and following changes that occurred in the following 50 years.
Diseases illustrated in this poster:
Already known diseases to which new knowledge was added – endemic goitre.
Grossly enlarged thyroids were common in the highlands. They were due to iodine deficiency. Histologically they showed multiple nodules of extremely hyperplastic follicle cells that were easily confused with being malignant. The goitres were dramatically reduced in size by the injection of iodine, and the condition was virtually eradicated in the next 20 years by the addition of iodine to the salt.
Endemic cretins were common and this condition disappeared when the women were treated with iodine.
Amyloidosis occurred in 7% of autopsies, and half the cases were primary in type. No cause was found. The prevalence of amyloidosis does not seem to have changed.
A new syndrome was recognised in children of renal disease and a goitre.
The degree of atherosclerosis in this population was less than in any previously studied population to that time. Myocardial infarctions and strokes were virtually unknown but since 1970, they have become a major cause of disability and death as the amount of fat in the diet increased.
One previously unknown disease that was described and then eradicated was Pigbel, caused by eating meat contaminated by the spores of Clostridium perfringens type C. A vaccine to the exotoxin eradicated the disease.
Advanced tumours – benign and malignant.
Unusual tumours – Burkitt lymphoma, Kaposi's sarcoma.
A few examples of miscellaneous conditions – albinism, sexually transmitted infections (with a high incidence of Donovanosis), yaws, Mycobacterium ulcerans, tropical ulcer.