i j : 4 Dr. Reeve’s Account of Cretinism. 
though frequent occurrence, into a general and necessary 
cause. Cretinism is frequently observed without any affection 
of the thyroid gland, and that gland is often very much en- 
larged without any affection of the intellectual faculties. There 
seems to be some similarity between cretinism and rickets, as 
they both take place in infancy, are both characterized by 
feebleness of body, and sooner or later by feebleness of mind, 
and they both affect males and females equally ; but there is 
no sort of connexion between persons afflicted with broncho- 
cele in England, and with rickets. For although it might be 
granted, that there is some delicacy of frame in females about 
the period of pubescence when, bronchocele usually occurs, 
yet neither irregular formation of the bones, nor weakness of 
the intellectual powers, are common symptoms attending 
bronchocele in Britain. 
To what peculiarities then, in the physical constitution of 
certain districts, are we to ascribe the production of this sin- 
gular malady? Saussure’s description of the Valais is ex- 
ceedingly precise and accurate, and the causes which he has 
alledged appear sufficient to account for the phenomena. The 
vallies where cretinism is most frequent, are surrounded by 
very high mountains ; they are sheltered from the currents 
of air, and exposed to the direct and still more to the reflected 
rays of the sun. The effluvia from the marshes are very 
strong, and the atmosphere humid, close, and oppressive. All 
the cretins that I saw, were in adjoining houses, in the little 
village called La Batia, situated in a narrow corner of the 
valley, the houses being built up under ledges of the rocks, 
and all of them very filthy, very close, very hot, and miser- 
able habitations. In villages situated higher up the mountains,. 
