Page:Proceedings of the Royal Society of London Vol 1.djvu/312

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The peculiar idiots, Cretins, which prevail in the Valais and in Switzerland, appear to have been ﬁrst described by Felix Plater in 1656; but the author of the present communication refers to Li. de Saussure for the most accurate account of the appearance of the dis- order; to hialacarni of Turin, and to Professor Ackerman, for a par- ticular description of several cretins that they dissected: and for a more full account of the malady, to the Essai sur le Goitre gt Cre- tim'sme, by Mons. Foderé.

By these and other accounts, Dr. Reeve’s curiosity was excited to examine what connexion could subsist between mental imbecility and that enlargement of the thyroid gland which so frequently accompa- nies it, and which, in general, ﬁrst attracts the notice, and has much occupied the attention, of those who have described cretinism. But this is not a constant attendant; while the more essential symptoms are, deformed head, diminutive stature, a sickly complexion, a vacant countenance, coarse and prominent eyelids, wrinkled and pendulous skin, with muscles proportionally ﬂabby. The qualities of the mind correspond to the outward appearance, and vary in all degrees, from common stupidity to complete fatuity.

Notwithstanding the assertions and ingenious reasoning of Foderé and other authors upon the supposed connexion between goitre and cretinism, the author is inclined to think, from the instances which he had an opportunity of observing in the neighbourhood of lVIar- tiguy, that the two disorders are perfectly distinct; and that though they frequently occur in the same person in countries where both dis- orders are endemial, yet no necessary cormexion subsists between them : for even there, many persons have goitre without cretinism, and many cretins have no goitre ; and in Britain, we know that no weakness of the intellectual powers accompanies bronchocele.

Dr. Reeve is inclined to ascribe this singular malady to peculiarities in the physical constitution of certain districts. The valleys where cretinism is most frequent, as Saussure justly observes, are surrounded by very high mountains; they are sheltered from currents of air, and are exposed to both the direct and reﬂected rays of the sun. The atmosphere is humid, close, and oppressive : the houses of the cretins are also generally in the most conﬁned situations, are very ﬁlthy, very hot, and miserable habitations; while in the more airy and elevated parts of the mountains, no cretins are to be seen.

The hypothesis, that snow-water is the cause of goitre and of cretinism, our author observes, is contradicted by the most obvious facts; since there are many places contiguous to glaciers where the inhabitants can drink nothing but snow-water, and yet are not subject to these disorders; which, on the contrary. do occur in some places where snow-water is unknown.

The theory also which ascribes them to waters impregnated with