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Robert E. Moran, M.D.
JAMA. 1937;108(20):1733-1734. doi:10.1001/jama.1937.02780200055024.
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To the Editor:—  In order to advance my theory of exophthalmos in exophthalmic goiter, based on 300 operative cases from September 1924 to March 1937 (a twelve and one-half years period) it is necessary to agree on certain fundamentals:

  1. That the exophthalmos is due to exophthalmic goiter.

  2. That exophthalmos is usually bilateral and in some relation to the severity of toxicity.

  3. That exophthalmos usually subsides when toxicity is removed.

  4. That exophthalmos is less frequent (60 per cent in my cases) since the advent of compound solution of iodine and since patients come early for surgery.

As the condition has not been understood, and as the literature is flooded with varied theories, my explanation to be tenable should have the following requisites:
  1. It must explain the varied anatomic physiologic and pathologic changes, beginning with the first eye sign, the stare, and covering the varied degrees of


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