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Some Account of Cretinism. By Henry Reeve, M.D. of Norwich. 

 Communicated by William Hyde Wollaston, M.D. Sec.R.S. Read 

 February 11, 1808. [Phil. Trans. 1808, p. 111.] 



The peculiar idiots, Cretins, which prevail in the Valais and in 

 Switzerland, appear to have been first described by Felix Plater in 

 1656 ; but the author of the present communication refers to M. de 

 Saussure for the most accurate account of the appearance of the dis- 

 order ; to Malacarni of Turin, and to Professor Ackerman, for a par- 

 ticular description of several cretins that they dissected ; and for a 

 more full account of the malady, to the Essai sur le Goitre et Cre- 

 tinisme, by Mons. Fodere. 



By these and other accounts, Dr. Reeve's curiosity was excited to 

 examine what connexion could subsist between mental imbecility and 

 that enlargement of the thyroid gland which so frequently accompa- 

 nies it, and which, in general, first attracts the notice, and has much 

 occupied the attention, of those who have described cretinism. But 

 this is not a constant attendant ; while the more essential symptoms 

 are, deformed head, diminutive stature, a sickly complexion, a vacant 

 countenance, coarse and prominent eyelids, wrinkled and pendulous 

 skin, with muscles proportionally flabby. The qualities of the mind 

 correspond to the outward appearance, and vary in all degrees, from 

 common stupidity to complete fatuity. 



Notwithstanding the assertions and ingenious reasoning of Fodere* 

 and other authors upon the supposed connexion between goitre and 

 cretinism, the author is inclined to think, from the instances which 

 he had an opportunity of observing in the neighbourhood of Mar- 

 tigny, that the two disorders are perfectly distinct ; and that though 

 they frequently occur in the same person in countries where both dis- 

 orders are endemial, yet no necessary connexion subsists between 

 them : for even there, many persons have goitre without cretinism, 

 and many cretins have no goitre ; and in Britain, we know that no 

 weakness of the intellectual powers accompanies bronchocele. 



Dr. Reeve is inclined to ascribe this singular malady to peculiarities 

 in the physical constitution of certain districts. The valleys where 

 cretinism is most frequent, as Saussure justly observes, are surrounded 

 by very high mountains ; they are sheltered from currents of air, and 

 are exposed to both the direct and reflected rays of the sun. The 

 atmosphere is humid, close, and oppressive : the houses of the cretins 

 are also generally in the most confined situations, are very filthy, very 

 hot, and miserable habitations ; while in the more airy and elevated 

 parts of the mountains, no cretins are to be seen. 



The hypothesis, that snow-water is the cause of goitre and of cre- 

 tinism, our author observes, is contradicted by the most obvious facts ; 

 since there are many places contiguous to glaciers where the inhabi- 

 tants can drink nothing but snow-water, and yet are not subject to 

 these disorders ; which, on the contrary, do occur in some places 

 where snow-water is unknown. 



The theory also which ascribes them to waters impregnated with 



