To the Editor: The most important problem in the field of thyroid disease today undoubtedly concerns the proper management of hyperthyroidism. Should a patient with this disease receive medical treatment followed by surgical treatment, or should he receive medical treatment alone? The problem is clear enough, and the solution is now perhaps almost as clear.There is an unfortunate tendency to accept thyroidectomy as an entirely satisfactory method of treatment, and it is true that in the best surgical clinics the operative mortality is extremely low. But the hoarseness of recurrent laryngeal nerve paralysis, the twitch and spasm of tetany . . .