Endocrinology

April 25, 2023

Dr. Henry S. Plummer (1847-1936) was a founding endocrinologist at Mayo Clinic in Rochester, Minnesota, and on staff from 1901 to 1936. Although perhaps best known for his description of toxic multinodular goiter, also known as Plummer disease, Dr. Plummer also was talented in ways beyond the practice of medicine. He developed the concept of a comprehensive medical record at Mayo Clinic and is credited with designing the hallmark integrated multidisciplinary approach to medical practice that Mayo Clinic is still based on today. Dr. Plummer's name also lives on in Plummer-Vinson syndrome, also called sideropenic dysphagia.

On the 100-year anniversary of the founding of the American Thyroid Association, John C. Morris III, M.D., an endocrinologist at Mayo Clinic in Rochester, Minnesota, and the past president of the American Thyroid Association, reflects: "Dr. Plummer was one of the early observers of a condition which at that time was known as 'exophthalmic goiter,' and which we now know as Graves' disease. In 1922, he administered iodine in the form of Lugol solution to patients with exophthalmic goiter before thyroidectomy. To his surprise, signs and symptoms of hyperthyroidism abated within days, and surgical mortality went down from approximately 5% to less than 1%."

Dr. Morris continues: "In addition to the impact on thyroidal blood flow, it is likely that a decrease or normalization of peripheral thyroid hormone levels contributed to the improvements in outcomes. This so-called Plummer effect describes the phenomenon that occurs when large intrathyroidal concentrations of iodide inhibit hormone secretion in patients with Graves' disease. These observations were subsequently confirmed by several other thyroidologists around the country."

To this day, the administration of iodine is one of the cornerstones in the treatment of thyroid storm, and it also can be used as an alternative to thionamides in some patients with hyperthyroidism. A century after the reported observations of Dr. Plummer, interest continues in understanding the role of inorganic iodide in thyroid hormone synthesis, secretion and transportation in animal and humans, as evidenced in a 2023 study published in Thyroid.

Dr. Henry S. Plummer became the ninth president of the American Association for the Study of Goiter, now the American Thyroid Association, in 1933. Several Mayo Clinic alumni have held this prestigious position, including:

1. Henry S. Plummer, M.D. (1933-1934)
2. Samuel F. Haines, M.D. (1950-1951)
3. Alexander Albert, M.D. (1961-1962)
4. F. Raymond Keating Jr., M.D. (1965-1966)
5. William M. McConahey, M.D. (1976-1977)
6. Alvin B. Hayles, M.D. (1979-1980)
7. Colum A. Gorman, M.B., B.Ch. (1996-1997)
8. Rebecca S. Bahn, M.D. (2007-2008)
9. Hossein Gharib, M.D. (2013-2014)
10. Robert C. Smallridge, M.D. (2014-2015)
11. John C. Morris III, M.D. (2016-2017)
12. Victor J. Bernet, M.D. (2020-2021)

For more information

Kopp PA. Iodine in the therapy of Graves' disease: A century after Henry S. Plummer. Thyroid. 2023;33:273.

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