700 ANNUAL REPORT SMITHSONIAN INSTITUTION, 192 8 



thought that therein lay its premier function. It gives a pleasing 

 fullness, a roundness to the contours of the neck, no doubt. This fact 

 was not lost sight of by many of the old masters, who carried the idea 

 to extremes and painted their maidens with necks which verged upon 

 the goitrous. 



The thyroid's greatest power for beauty, however, lies not in its 

 size or its shape, but in its secretion. Everyone who has ever seen one 

 of those unfortunates who, from birth or shortly after, had been 

 deprived of his thyroid secretion will know what I mean. 



In Switzerland, in the valleys of the Alps, there was to be seen 

 a type of dwarf known as a cretin. A cretin is the direct result of 

 the absence or extreme deficiency of the thyroid hormone. These 

 individuals were truly the most pitiable and grotesque parodies on 

 mankind. They were stunted and deformed in stature and mentally 

 defective or quite imbecilic. Their features were misshapen and 

 flabby. The brow was low, the bridge of the nose depressed, and the 

 nostrils wide; the tongue appeared too large for the mouth, which 

 was coarsely molded. The skin was thick and the hair dry and 

 sparse. I think the description of Caliban must have been inspired 

 by the poet having at one time seen a cretin. Cretins never grew 

 up, but remained for the rest of their lives children in mind and 

 body. Yet had they been Peter Pans — attractive, happy, and intelli- 

 gent children — all might have been well. But no ; they dragged their 

 uncouth bodies through a drab existence, a burden to themselves and 

 their families, or a charge upon the community. The word " cretin " 

 is simply a corruption of the French for " Christian " — chretien — 

 used in the same sense as the English words " innocent " or " simple " 

 are applied to the feeble-minded. 



Though cretins were more common in Switzerland than in other 

 parts of Europe, they were by no means confined to that country. 

 Osier, " within a few years," as he says, was able to collect the his- 

 tories of 58 cases in Canada and the United States. Cretinism was 

 at one time not uncommon in England, especially in Derbyshire. 

 But it was in the valleys of the Alps, of the Pyrenees, in the Tyrol, 

 and in the Himalayas that it was seen most frequently. 



It was not until the gland was removed in young animals that a 

 clue to the cause of the condition was uncovered. Sir Victor Horsley, 

 the famous London surgeon, performed this operation upon monkeys 

 and showed that the symptoms which followed were practically 

 identical with human cretinism. Through this work the responsi- 

 bility for the cretin was definitely fastened upon the thyroid. This 

 was the gland at fault. 



The questions had still to be answered : " Why is cretinism com- 

 mon in certain regions and practically unknown in others?" "Why 

 does the gland faij to perform its proper functions?" The most gen- 



