Cretinism

Cretinism (Fr. crétin, 'an idiot;' probably from chrétien, 'a Christian,' an 'innocent'), idiocy or defective mental development, associated with bodily deformity or arrested growth, occurring along with Goitre (q.v.) or enlargement of the thyroid gland, in the lower mountain valleys of the Swiss and Italian Alps, of the Pyrenees, of Syria, India, and China. In Europe it is rarely found above 3000 feet, and haunts chiefly valleys surrounded by high and steep walls of rock, which exclude the light, and limit the free circulation of air. In some such localities it is extremely prevalent. Cretins are always pitiable and frequently repulsive objects; they are generally dirty, shameless, and obscene; their appetite is commonly voracious; the mouth is large and open, the tongue often protruded, the eyes small, the nose flat and broad, the skull flattened above and expanded at the sides, the forehead retreating, the complexion cadaverous; in addition to which, the whole body is dwarfish, the skin thick and coarse, the hands and feet large, the limbs often rickety, the belly protuberant. Recent investigations have shown that the connection between cretinism and goitre is an extremely close one. The disease called Myxœdema (q.v.) closely resembles cretinism, except that it comes on during adult life; and it has been proved to be always associated with destructive change of the thyroid gland. A similar condition has also been found to follow the removal of the thyroid gland by surgical operation in a large proportion of cases. It is, therefore, probable that loss of the function of the thyroid gland is the essential factor in the production of cretinism, while goitre consists in its enlargement. It is as yet quite uncertain, however, why the inhabitants of particular districts are so liable to disease of this organ. Many attempts have been made to improve the condition of the cretin in childhood, by removing him from the locality of his birth, and by careful training; the institution founded by Dr Guggenbühl on the Abendberg, near Interlaken in Switzerland, having been the prototype of many others on the Continent, and of some in England and Scotland, for the education of idiots.