Licence: Public Domain Mark
Credit: On sporadic cretinism in America / by William Osler. Source: Wellcome Collection.
Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.
10/18
Licence: Public Domain Mark
Credit: On sporadic cretinism in America / by William Osler. Source: Wellcome Collection.
Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.
![special extent.” Dr. R. J. Preston, of the Southwestern Lunatic : Asylum, Marion, Virginia, has very kindly made inquiries as to the i existence of the disease in some of the southwestern counties of that State,. in which, as stated in Gibson’s Surgery, the disease formerly prevailed, and here, too, it seems to have almost disappeared. Dr. W. Taylor, of ’ Talladega, Alabama, who is the authority quoted by Hirsch in support. of the statement that there is a “ good deal of it ” in the northern counties of that State, writes (1893) : “ Since that time [1854] my views i on the subject hav^e been greatly modified. With a much larger popu- lation there are now really fewer cases of goitre to be found in Talladega . and adjacent counties than in the earlier period of their history The fact remains that there has been a great decrease in the prevalence of goitre during the past thirty years, and the percentage of cases will not surpass the average in other States and communities.” In the Province of Quebec cases of goitre are by no means rare, and in Montreal the disease is certainly more frequent in hospital practice than in Philadelphia or Baltimore. I have no information of any localities - in which it could be said to be endemic, attacking a very large number of persons. In the neighboring Province of Ontario, in the limestone regions at the end of Lake Ontario, the disease is very prevalent. In response to my inquiry about cretins. Dr. C. K. Clark, of the Kingston Asylum, , mentions the extraordinary prevalence of the disease. Thus in an asylum population of about 600 there are 288 cases of goitre. He ^ writes: “ The goitres are generally developed when the patients are admitted to the asylum, and it is rarely indeed that we see recent cases unless among the employes. After studying the subject carefully I have come to the conclusion that Eastern Ontario is a distinctly goitrous district, and I do not believe that outside practitioners have given the • matter any attention. It is difficult to get accurate statistics even from asylums, and for this reason I have never published the returns sent in from nearly every hospital for the insane in America. A superintendent would answer my circular and state that his institution was without goitrous patients. I would go to his institution myself and probably Bnd twenty or thirty goitres. The inference was plain, and when insti- tutions side by side gave returns showing marked diflbrences the infer- ence was plainer still. “ Outside practitioners about Kingston have written nothing of interest in connection with the subject, but I find goitre prevalent even among ;;he lower animals ; most of the curs about the asylum have goitres, some ■ M them so large that anyone can notice them. The tendency to this ■ disease seems to run in certain strains, and the young of some families of logs and horses are invariably goitrous. In two cases of human beings](https://iiif.wellcomecollection.org/image/b24761795_0012.jp2/full/800%2C/0/default.jpg)
