formity and degradation of the inhabitants. By the roadside, basking in the sun, he beholds beings whose appearance seems such a caricature upon humanity, that he is at a loss to know whether to assign them a place among the human or the brute creation. Unable to walk,— usually deaf and dumb,—with bleared eyes, and head of disproportionate size,— brown, flabby, and leprous skin,—a huge goitre descending from the throat and resting upon the breast,—an abdomen enormously distended,—the lower limbs crooked, weak, and ill-shaped,—without the power of utterance, or thoughts to utter,—and generally incapable of seeing, not from defect of the visual organs, but from want of capacity to fix the eye upon any object,—the cretin seems beyond the reach of human sympathy or aid. In intelligence he is far below the horse, the dog, the monkey, or even the swine; the only instincts of his nature are hunger and lust, and even these are fitful and irregular.
The number of these unfortunate beings in the mountainous districts of Europe, and especially of Central and Southern Europe, is very great. In several of the Swiss cantons they form from four to five per cent. of the population. In Rhenish Prussia, and in the Danubian provinces of Austria, the number is still greater; in Styria, many villages of four or five thousand inhabitants not having a single man capable of bearing arms. In Würtemberg and Bavaria, in Savoy, Sardinia, the Alpine regions of France, and the mountainous districts of Spain, the disease is very prevalent. The causes of so fearful a degeneration of body and mind are not satisfactorily ascertained. Extreme poverty, impure air, filthiness of person and dwelling, unwholesome diet, the use of water impregnated with some of the magnesian salts, intemperance, (particularly in the use of the cheap and vile brandy of Switzerland,) and the intermarriage of near relatives and of those affected with goitre, have all been assigned, and with apparently good reason; yet there are cases which are attributable to none of these causes.
The disease is not, however, confined to Europe. It is prevalent also in China and Chinese Tartary, in Thibet, along the base of the Himalaya range in India, in Sumatra, in the vicinity of the Andes in South America, in Mexico; and sporadic cases are found along the line of the Alleghanies. It is said not to occur in Europe at a higher elevation than four thousand feet above the sea level.
The derivation of the name is involved in some mystery; most writers regarding it as a corruption of the French Chrétien, as indicative of the incapacity of these unfortunate beings to commit sin. A more probable theory, however, is that which deduces it from the GrisonRomance Cretira, "creature."
The existence of this disease has long been known; references are made to it by Pliny, as well as by some of the Roman writers in the second century of the Christian era; and in the seventeenth and eighteenth centuries its prevalence and causes were frequently discussed. Most of the writers on the subject, however, considered the case of the poor cretin as utterly hopeless; and the few who deemed a partial improvement of his health, though not of his intellect, possible, merely suggested some measures for that purpose, without making any effort to reduce them to practice. It was reserved for a young physician of Zürich, Doctor Louis Guggenbühl, whose practical benevolence was active enough to overcome any repugnance be might feel to labors in behalf of a class so degraded and apparently unpromising, to be the pioneer in an effort to improve their physical, mental, and moral condition.
It is now twenty-one years since this noble philanthropist, then just entering upon the duties of his profession, was first led by some incidents occurring during a tour in the Bernese Alps to investigate the condition of the cretin. For three years he devoted himself to the study of the disease and the method of treating it. Two years of this period
