90 i On Tdiotism. 
from the neck the size of quart bottles. 
When the tumour is found thus large and 
combined with absolute idiocy, it never fails 
to be described by the traveller with the ut- 
most horror and disgust, and when the situa- 
tion of the Thyroid gland is considered, and 
its connexion with the Larynx and Trachea, it 
is surprising that death by suffocation is not 
produced long before so great a magnitude 
is attained. 
The endemic which is the subject of this 
paper has not so far as I know been connect- 
ed with goitre in any of the individuals or 
their families, although the goitrous tumour 
is frequently met with in the neighbourhood, 
particularly in young females, nor have these 
two affections been hitherto found connected 
in England except by accident. It ought to 
be stated that in the short account given by 
the writer of the article Cretin in Rees’s Cy- 
clopedia, we are told that some years ago a 
female Cretin of the name of Sothern resided 
at Hull, and another at Plymouth. 'The only 
case in which I have seen defect, in any part 
of the nervous system conjoined with Goitre, 
isin a young female at Hollinwood, who is 
deaf and dumb, with very considerable full- 
ness of the neck. (a) 
(a) Since reading this paper I have been furnished with some in- 
