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302 chemically impure water, and especially hard water; and the investigations of various observers have discovered that goître has an intimate connection with certain geological formations. In harmony with these facts, it is found that infants are seldom born with goîtres, but that they develop as the child grows up; that they will sometimes appear and disappear from mere change of locality; and that it is possible to produce them intentionally.

It is not so certain that the causes which produce goître should be regarded as causes of the production or maintenance of crétinism. It is true that crétins are very generally goîtrous, but it is also true that there are tens of thousands of goîtrous persons who are entirely free from all traces of crétinism. Not only so, but that there are districts in the Alps, and outside of them (even in our own country), where goître is not rare, but where the crétin is unknown. Still, regarding the evil state of body which leads to goître as being, possibly, in alliance with crétinism, it will not be irrelevant to give the former disease a little more attention before continuing the consideration of the main subject.

In this country the possession of a goître is considered a misfortune rather than otherwise, and individuals who are afflicted with these appendages attempt to conceal their shame. In the Alps it is quite the reverse. In France, Italy, and Switzerland, it is a positive advantage to be goîtred, as it secures exemption from military service. A goître is a thing to be prized, exhibited, preserved—it is worth so much hard cash; and it is an unquestionable fact that the perpetuation of the great goîtrous family is assisted by this very circumstance.

When Savoy was annexed to France, the administration took stock of the resources of its new territory, and soon discovered