Cretinism historical perspective
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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.
Etymology and usage of the term
The term cretin was brought into medical use in the 18th century from an Alpine French dialect. It was used widely as a medical term in the 19th and early 20th centuries, but in recent decades has spread more widely in popular English as a markedly derogatory term for a person who exhibits stupid behaviour. Because of its pejorative connotations in popular speech, the term has been largely abandoned by physicians and health care workers.
The etymology of the word cretin is not known with certainty. Several hypotheses have been proposed. The most common derivation provided in English dictionaries is from the Alpine French dialect pronunciation of the word Chretien - (a) Christian, which functioned as a form of greeting in those parts. According to the Oxford English Dictionary, the translation of the Latin term into "human creature" implies that the label "Christian" is a reminder of the humanity of the afflicted, in contrast to brute beasts [1]. Other sources have suggested "Christian" refers to the "Christ-like" inability of such a person to commit sin, because of an incapacity to distinguish right from wrong [2].
Other speculative etymologies have been offered:
- From creta, Latin for chalk, because of the pallor of those affected.
- From cretira, Grisson-Romance creature, from Latin creatus.
- From cretine, French for alluvium (soil deposited by flowing water), an allusion to the suspected origin from inadequate soil.[3]
References
- ↑ {{cite web | url = http://dictionary.oed.com/cgi/entry/50053852 | title = "cretin" | work = Oxford English Dictionary | accessdate = 2005-12-11
- ↑ Brockett, Linus P (Feb 1858). "Cretins And Idiots". The Atlantic Monthly. Retrieved 2005-12-11.
- ↑ Medvei, VC (1993). The History of Clinical Endocrinology. Pearl River, New York: Parthenon Publishing Group.