A discussion on sporadic cretinism in this country and its treatment / by W. Rushton Parker [and others]. Tendency to bending of the bones in cretins under thyroid treatment / by T. Telford-Smith.

  • Parker, William Rushton.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: A discussion on sporadic cretinism in this country and its treatment / by W. Rushton Parker [and others]. Tendency to bending of the bones in cretins under thyroid treatment / by T. Telford-Smith. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    Dr. George Murray (Newcastle-on-Tyne) mentioned that he had seen an increase in the vocabulary of cretins after treatment by thyroid extract. In one case micturition had been involun- tary before treatment, but became normal afterwards. Various types occurred according to the age at which the thyroid became diseased, and according to the amount of injury done to the gland. A good plan in carrying out the treatment in adult cretins was to begin with one minim of the thyroid extract each day, and to increase the dose by a minim each month till the limit of tolerance was reached. The President (Dr. J. Finlayson) said that he had had an interesting case under observation, in which the treatment was irregularly carried on, andthepatient subject to relapses in consequence. The child in question did, however, grow 4| inches in two years, and learnt to speak under treatment. It was a difficult matter among the poorer classes to secure the treatment of a child for all the rest of its life. Grafting was useless with a hope of securing permanent benefit. Dr. Draper thought that in cases of semi-cretinism where there was some lordosis, slight umbilical hernia, rickets, and some mental difference from other children that thyroid treatment might prove valuable. Such cases often existed undiscovered. Backward children might be improved in the same way. A patient under his care had been at school from io years old, and at 18 could not count. Her weight had increased by 4 stone in one year. Under thyroid treat- ment she improved much, lost weight, and her temperature rose to normal. The thyroid extract had to be discontinued on account of the rapidity of pulse which it produced in doses of 3 grains. In another case the temperature remained normal with 1 grain doses, but rose to ioo° if two powders were given daily. Dr. Oliphant Nicholson (Kirkcaldy) said that, with regard to the etiology of cretinism, it would be interesting to acquire more information on the geographical distribution of the disease, and compare the geological formation of the specially affected areas; also their situation and peculiari- ties. At present the data were insufficient to enable us to say whether or not the geology of a district had anything to do with the occurrence of cretinism, and if the disease was in any way connected with the presence of an excess of soluble salts of lime or iron in the drinking water one would expect to find a large number of cases ? a London and along the valley of the Thames. But if tpec: ,lly affected cretinous districts were mapped out all over the globe, or even over the British Isles, one might find some common element existing as a possible factor in the causation of the disease. Then any relation between ordinary goitre and cretinism should be more carefully studied, and it might be found that a speci- ally goitrous district was also a cretinous one. Some thirty years ago at Penrith in Cumberland, simple goitre was a fairly common disease, and now it was a comparatively rare one, possibly because the town was supplied with river water, while formerly the inhabitants were much more dependent on well water containing a large percentage of lime salts from the red marls and limestones of the district. Goitre was, however, still not uncommon in the country villages along the Eden Valley, and cretins would seem to be found oftener in the English lake district than in any other part of Britain.