The nature of the selective concentration of iodine in the thyroid gland is not yet absolutely clear; but be it determined enzymatically or otherwise, it is the first step in the synthesis of thyroid hormones. Theoretically, an impairment of the trapping mechanism of the iodine by the thyroid gland could be a cause of sporadic goiter, but only one such case has been described (Stanbury and Chapman 1). Report of Cases A 14½-year-old boy was seen for the first time in April, 1959, because of a swelling of the anterior region of the neck. The family history revealed that an elder brother had suffered from goiter and myxedema since early childhood and had received continuous thyroid medication. The parents were healthy and unrelated. During the first months of life the patient was apathetic, had severe constipation and a very dry skin, and failed to develop normally. The family physician made