702 ANNUAL REPORT SMITHSONIAN INSTITUTION, 19 2 8 



growth. Myxedema was common in the same regions where cretms 

 were found. 



In my discussion of cretinism and myxedema I have deliberately 

 kept to the past tense, for the very good reason that they are practi- 

 cally things of the past. Medicajl science in its progress has swept 

 them from its path. We might travel through the Alps to-day and 

 I do not think that we should see a single cretin unless it was a case 

 of long standing. 



Cretins and myxedematous subjects owe their changed fortunes to 

 an English physician, Dr. George Murray, now emeritus professor 

 of medicine at Manchester. It occurred to this investigator to extract 

 the thyroid glands of sheep with glycerine and to inject this into the 

 subjects of thyroid deficiency. It is interesting to recall how this 

 idea first came to Murray. He read of an operation performed by 

 two foreign surgeons, Bettencourt and Serrano, in which they had 

 acted upon the suggestion of Sir Victor Horsley and grafted a por- 

 tion of a sheep's thyroid beneath the skin of a victim of thyroid defi- 

 ciency. They reported an improvement in the condition. Murray 

 says, " this observation indicated to me that the gland carried on its 

 functions by means of an internal secretion." He therefore con- 

 cluded that it might be possible to extract this secretion from the 

 glands of animals and that it might serve as a suitable substitute 

 for the secretion that was lacking. In 1891 he reported the results 

 of his first trials with the extract. 



Of all the discoveries in the field of medicine this was one of the 

 most brilliant. The extract fulfilled the hopes of even the most 

 sanguine. Its success was complete. It was able within a remark- 

 ably short time to conquer all the symptoms of thyroid deficiency 

 in the adult, that is, myxedema. 



His success with the cretin depended upon how long the condition 

 had existed before treatment had been commenced. Obviously not 

 such great benefits could be expected in a case which had existed for 

 years where brain, bone, and muscle had been confirmed in their 

 abnormal state. Yet even in these the improvement was often very 

 striking. But in the early cases the effects appeared to be little short 

 of miraculous. No potion brewed in magic caldron ever produced a 

 greater change than did Murray's extract. As though enchanted, 

 the stunted and gnomelike body of the cretin grew to normal pro- 

 portions. The ugly mask fell from the face, and the limbs took on 

 the human grace which nature had hitherto denied them. But, great- 

 est benefit of all, the light of reason returned to the clouded mind and 

 in a short time these apparently hopeless imbeciles were turned into 

 happy and intelligent children. It is no longer necessary to inject 

 the extract, for it can now be taken in tablets. To-day there should 

 be no cretins under 40 years of age. If one younger than this should 



