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This paper gives a short survey of the history of hypothyroidism and its treatment.

During the 50 years preceding World War I, medicine saw a wealth of new ideas and novel procedures, not in the least within the field of endocrinology.

Among major achievements of this period were the recognition of the importance of the pituitary gland, first suggested by Oscar Minkowski (1858–1931) [1] and introduction of pituitary surgery [2]—not only for pituitary tumors but also as treatment of acromegaly [3]; the delineation of hypopituitarism as a nosological entity [4]; the discovery in 1877 (by a medical student) of the parathyroid glands [5] and recognition of their vital importance [6]; introduction of thyroid surgery, pioneered by Rehn [7], Theodor Billroth [8] and above all Theodor Kocher (1841–1917) [9]; Minkowski’s demonstration that pancreatectomy swiftly leads to severe diabetes mellitus [10].

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The thyroid gland evolved from being considered a rudimentary structure to an organ related to specific diseases.

The last part of the 19th century was a period of great achievements in medicine and endocrinology.

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The singular importance of iodine became acknowledged. Surgical treatment evolved with extraordinary speed. Theodor Kocher observed that the clinical picture in patients after total thyroidectomy was similar to the one seen in cretinism.

In 1850, the first case of hypothyroidism or myxedema was described.

Less than 50 years later, effective treatment was introduced.

Another 50 years later, autoimmune thyroiditis was ascertained as the most frequent cause of hypothyroidism (in areas with no iodine deficiency).