Cretinism historical perspective
|
Cretinism Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Cretinism historical perspective On the Web |
|
American Roentgen Ray Society Images of Cretinism historical perspective |
|
Risk calculators and risk factors for Cretinism historical perspective |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Historical Perspective
Endemic cretinism was especially common in areas of southern Europe around the Alps and was described by Roman writers, and often depicted by medieval artists. Alpine cretinism was described from a medical perspective by several travellers and physicians in the late 18th and early 19th centuries. At that time the cause was not known and it was often attributed to "stagnant air" in mountain valleys or "bad water". The proportion of people affected varied markedly throughout southern Europe and even within very small areas it might be common in one valley and not another. The number of severely affected persons was always a minority and most persons affected by cretinism to the extent of having a goiter and some degree of reduced cognition and growth were still socially functional in their pastoral villages.
More mildly affected areas of Europe and North America in the 19th century were referred to as "goiter belts". The degree of iodine deficiency was milder and manifested primarily as thyroid enlargement rather than severe mental and physical impairment. In Switzerland, for example, where soil is poor in iodine, the cases of cretinism were very abundant and even were considered to be genetically caused. As the variety of food sources dramatically increased in Europe and North America and the populations became less completely dependent on locally grown food, the prevalence of endemic goiter diminished.
In the early 20th century the relationships of sporadic cretinism with congenital hypothyroidism, and endemic cretinism with hypothyroidism due to iodine deficiency were discovered and both have been largely eliminated in the developed world.