This name is applied to a condition in which the body is stunted from deficient growth of the long bones, the nose is sunk from imperfect growth of the base of the skull, the head is proportionally large and the neck short, and the intellect is very defective. It is mostly endemic, but sporadic cases occur. The thyroid gland is affected in almost all cases of cretinism, and the condition has been ascribed to disease of the gland either of congenital origin or occurring in early life. The condition of the thyroid gland is not always the same. There may be a regular goitre, and it is interesting that goitre and cretinism are sometimes endemic in the same localities. In other cases the thyroid gland is cystic, and in others it is atrophic. It is to be remarked that an apparent enlargement of the thyroid may be associated with atrophy of its proper secreting tissue, and that goitre is often associated with defect in the function of the gland.

There are several grounds for regarding cretinism as due to disease producing defect in the secretion of the thyroid. One of these is that the phenomena closely resemble those of myxcedema or cachexia strumipriva, especially when these have been observed in the young subject. The fact that Gull applied to myxcedema the name of cretinoid state is evidence of the close resemblance between the two conditions. Again, it has been found that in some cases where children presenting the general symptoms of cretinism have been treated with thyroid gland they have shown much improvement. It is expected by many that the endemic cretinism of some localities may be in part overcome by this treatment, but sufficient time has not elapsed to bring the matter fully to the test.

If this view of the nature of cretinism be correct, then it may be asserted that the loss of the thyroid secretion, when it occurs at an early age, causes defective growth of the bones and such a dulling of intellect as to constitute idiocy.

Literature

Gull, Trans, of Clin. Soc. of London, 1873; Ord, Med. chir. trans., 1877, also in Allbutt's Syst. of Med., iv., 1897 (with literature), and Lancet, 1898; Reverdin, Rev. med. de la Suisse Rom., 1883 and 1887; Kocher, Arch. f. Chirurgie, xix., 1883; Virchow, Berl. klin. Wochenschr., 1887; Horsley, Festschr. f. Virchow, 1891; De Quervain, Virch. Arch., cxxxiii., 1893; Boyce and Beadles (Hypert. of pituitary), Jour, of path., i., 223. A very full account of Myxcedema, with history and literature in Report to Clin. Soc. of London, 1888. In this, papers by Ord, Haliburton, Horsley, Semon, etc.; Ewald, Die Erkrank. d. Schildruse, 1896.