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 merely that it was almost unknown upon the plains to the east and in the districts to the west, but that the valleys radiating north and south from the main valley were practically unaffected by it. For it is a remarkable circumstance, which has attracted the notice of all who have paid attention to crétinism, that the natives of the tributary valleys are almost free from the malady;—that people of the same race, speaking the same language, breathing the same air, eating the same food, and living the same life, enjoy almost entire immunity from it, while, at the distance of a very few miles, thousands of others are completely in its power.

A parallel case is found, however, on the other side of the Pennine Alps. The Rhone valley is almost equally disfigured by crétinism, and in it, too, the extremities of the valley are slightly affected compared with the intermediate districts—particularly those between Brieg and St. Maurice This second example strengthens the conviction that the great development of crétinism in the middle of the valley of Aosta is not the result of accidental circumstances.

It was formerly supposed that crétinism arose from the habitual drinking of snow and glacier-water. De Saussure opposed to this conjecture the facts, that the disease was entirely unknown precisely in those places where the inhabitants were most dependent upon these kinds of water, and that it was most common where such was not the case;—that the high valleys were untainted, while the low ones were infected. The notion seems to have proceeded from crétins being confounded with persons who were merely goîtred; or, at least, from the supposition that goître was an incipient stage of crétinism.

Goître, it is now well ascertained, is induced by the use of