268 
IOWA ACADEMY OF SCIENCES 
On this continent the condition of Cretinism has been supposed to 
be rare. Dr. Osier in 1897 was able to report but sixty cases in the 
United States. I have knowledge, at this date, of but nine such individ- 
uals in Iowa. 
The ductless thyroid gland in health is so inconspicuous that some, 
even in this audience, may not be aware of its location in the front of 
the lower part of the neck. When enlarged it forms the goitre so fre- 
quent as to be familiar to all. On section the ascini of this gland maj^ be 
found tilled with a colloid material which is not yet thoroughly under- 
stood. In just what way the secretions of this gland influence our system 
is not yet definitely determined. The fact is well established, however, that 
if the function of the thyroid is abrogated the individual so affected ex- 
periences an almost complete cessation of physical and mental develop- 
ment. 
The child without a thyroid gland appears at birth normal. It must 
in its uterine life receive the mother's thyroid secretions through the 
placental circulation. Soon after birth — as early as the second month — 
the abnormal condition begins to appear. It is probable that the moth- 
er's milk in part supplies a stimulus to growth for the development is 
usually more rapid during the first year than at any later period. In 
my personal experience the early development has been proportioned to 
the supply of nourishment from the mother's breast. When this is abun- 
dant and long continued the baby finally attains the stature of the nor- 
mal child of three years of age. Then growth in height practically 
ceases. The phenomenon is striking in the extreme. Dentition, growth, 
speech, mental acquirements and the development of puberty are delayed 
or arrested. The infantile state is prolonged indefinitely and a merely 
vegetative existence supervenes. There is a deposit of a mucoid sub- 
stance beneath the skin which produces some deformity and a peculiar 
appearance easily recognized. 
When such an individual is discovered, then one of the triumphs of 
modern medicine is made possible for at any time from the first to the 
twentieth year (and possibly later) in the life of the Cretin, growth and 
development will be resumed (in most cases) , if the products of the 
thyroid gland of some animal are supplied as a food. This today is 
accomplished by the artificial feeding of the dried and compressed thyr- 
oid gland of the sheep. 
As typical illustration of this curious condition, ^it is my privilege 
to present to you a series of photographs of t-wo Iowa girls who exhibit 
sporadic Cretinism due to a congenital absence of the thyroid gland. 
The first was two years old for eighteen years and then, after thyroid 
feeding was begun, she rapidly advanced through a belated childhood. 
For her the years from two to twenty have been of little consequence. 
While time stepped for her the other children of the family were born, 
passed puberty and attained mature stature. Now these actually younger 
brothers and sisters treat this older sister as a baby without realizing 
the anomaly. 
