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 Wuertemberg 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 _Chretien_, as indicative
of the incapacity of these unfortunate beings to commit sin. A
more probable theory, however, is that which deduces it from the
Grison-Romance _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 Zurich, Doctor
Louis Guggenbuehl, whose practical benevolence was active enough to
overcome any repugnance he 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 mora