On sporadic cretinism in America / by William Osler.

  • Osler, William, Sir, 1849-1919.
Date:
1893
Catalogue details

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.

    9/18
    Last year two cases were reported ; one by Lloyd,' from the Phila- delphia Hospital: the other by C. W. Townsend,“ of Boston. Huber, in the discussion on Townsend’s case, stated that the disease was not very uncommon among the children “ in the tenement districts of New York, owing to the influx of immigrants,” but no definite data are available as to the facts of its prevalence. Endemic Goitre.—Endemic cretinism occurs only in localities in which goitre prevails extensively, and the above observations, which have led in Europe to statements as to the prevalence of it here in endemic form^ have been based in reality upon incidental references to, and studies upon, goitre, made fi)r the most part in the early pait of the century. So far as I can learn, the disease has not and does not occur endera'ically in this country. It may be interesting to note certain facts about goitre which I have gleaned in my inquiries, but which, however, refer to this malady only so far as it might be related to the existence of cretinism in a locality. Hirsch ^ is again our chief authority as to its prevalence; and, as he remarks: “Our information on the endemic occurrence of goitre in North America belongs for the most part to the early years of this century and is very fragmentary.” Barton’s memoir already referred to, and the articles of W. Gibson^ and of Mease con- tain the most authentic information as to its prevalence, from which •subsequent writers have drawn their information. Without entering into details which are available in Hirsch’s work, it may be stated that . goitre has been described as prevailing among the French Canadians along the Detroit River, and along the Richelieu River between St. John and Montreal; in the valleys of Vermont and New Hampshire; in the central parts of New T ork about the smaller lakes; in Central Pennsylvania; in the mountainous districts of Maryland, Virginia, and : the Carolinas; and in Alabama. From a majority of these localities j we have no recent observations. I have written to a number of physi- i cians in the towns of New England mentioned by Dorr® as very much 1 affected, and so far have had only negative answers. Thus Dr. R. Clark, writing from Windsor, Vermont, one of the towns mentioned by the early writers, says that in the past fifty years he has not heard of its , being very prevalent; and Dr. Emerson, who formerly practised at 1 I Chester, Vermont (a town one-half of the inhabitants of which were stated by Dorr [1806] to be subjects of goitre), writes that During seven years’ residence in Vermont I do not recall seeing more than three or four cases of goitre, and I do not think that it prevails to any ' International Clinics, vol. ii., series 2. - Archives of Ptccliatrlcs, Nov. 1892. Op. cit., p. 149. < The Philadelphia Journal of the Medical and Physical Sciences, vol. i., 1820. ’’ American Medical Recorder, Philadelphia, 1818. “ New York Medical Repository, 1806.