The history of a cretin runs somewhat as follows: A baby is born, which in all appearances seems normal. Perhaps the nose is a trifle squatter than even the average new-born's flat nose. There may also be abnormal sleepiness, greater even than that of the normal baby in the first month or two in that there is no spontaneous awakening from the coma for food. But in most cases this is put down to normal variability, or maybe to that limbo of all a baby's troubles: weakness. After some months, it is noticed that the infant is failing to grow at the normal rate, either physically or mentally. Examination at this time reveals a curious thickening of the dental ridges. Then the tongue takes the centre of the scene, by becoming unusually thick and prominent, to the point of projecting beyond the mouth at all times, and interfering with breathing, when the infant is in a recumbent position.
More and more of the characteristics of the affection turn up. The queer, repulsive, pitiful face of the cretins, which makes them all seem brothers or twins, shapes itself. A yellowish, white or waxy pallor; rough, dry, scaly, bloated skin; swollen, often wrinkled brow; watery eyes, often almost concealed by the thickened eyelids; the depressed pug nose with its wide, thick nostrils; large, erect ears; the wobbly, drooling tongue, sticking out at one, yet not in derision; the hair thin, and like tow in texture rather than human; eyebrows and eyelashes are scant, and often absent; the nails short, thin and brittle; the teeth, very late in coming, may be represented by a few sharp points, irregular, decaying quickly, sometimes not succeeded at all by those of the second dentition.
Whatever growth occurs is irregular and disproportionate. The trunk, though small compared with the head, appears massive against the background of the diminutive extremities. The back is somewhat humped, arching at the waist-line, while the abdomen protrudes like a balloon, with a hernia, often, at the navel. The extremities are short, bowed, cold, and livid, covered with rolls of the infiltrated skin, rolls which cannot be smoothed out. Hands and feet are broad, pudgy, and floppy, the fingers stiff, square and spade-like, the toes spread apart, like a duck's, by the solid skin. Above the collar bones there are frequently great pads of fat which sometimes encircle the narrow bull neck.
The mental state varies with the degree of deprivation of the internal secretion of the thyroid. In the worst cases it is repulsively vegetable. Even the intelligence common to the higher animals is wanting. The cretins of the "human plant" kind, as they have been nicknamed, will not recognize mother or father or any person about them, or even a person from an object, and manifest no interest in anything or anybody, not even toys. Hunger and thirst they manifest by grunts and inarticulate sounds, or by screaming. They neither smile, cough, nor laugh, but sit like sphinxes, breathing, but not reacting.
There are, of course, all grades and varieties. There are those who recognize parents and familiar faces, and exhibit some evidence of affection for them, acquire a limited vocabulary, and then cease, no progress possible even with the alphabet. They attain the size and age of two or three years and there stop altogether, as if a permanent brake were applied to the wheels of their growth. Some higher types may even come to speak connected sentences, and exhibit a certain mild spontaneity, though stupid and slow and abnormally deliberate, resembling the acquired form of thyroid deprivation or insufficiency, for which Ord invented the name myxedema.
I have filled in with some detail this thumbnail sketch of thyroid deprivation as it occurs in infancy to illustrate how wide a sweep the gland's lariat embraces. Skin, hair, bones, muscle and fat, brain and intelligence, growth and development, are modified precisely as the size and shape of certain crystals are modified by the presence or absence of ingredients in an apparently homogeneous solution. A fertilized ovum, in which the predecessor of the thyroid gland is present, that is to say, in which there is the seed and soil for its sprouting, looks the same as one without that formative material. Yet, when the time comes for the internal secretion of the thyroid to put in its oar in the metabolic game, its presence or absence makes all the difference in the world to the individual.
In the middle of the nineteenth century, when the concentration of phosphorus in the brain was established as significant, the cry for the emphasis of that fact was—without phosphorus no thought is possible. We can much more relevantly declare that without thyroid, no thought, no growth, no distinctive humanity or even animality is possible. For the epigram about phosphorus was bombast, since it can be declaimed with equal truth that without oxygen, without carbon, without nitrogen, without any of the food elements that go to make up the chemical composition of brain matter, no thought is possible. Indeed, if one were set upon the indictment of a single chemical element as the begetter of consciousness, the prisoner at the bar would have to be copper. There is more copper in the brain by a considerable degree than in any other organ of the body. Which perhaps will be exceedingly regretted by the patrons of the aristocracy of the soul who would have it as an emanation of a deposit in the brain of silver at least, if not gold. They are like the old lady who would never permit herself to be cured of her ailments except by gold plated pills. Copper, however, is not necessary to intelligence. Without thyroid there can be no complexity of thought, no learning, no education, no habit-formation, no responsive energy for situations, as well as no physical unfolding of faculty and function, and no reproduction of kind, with no sign of adolescence at the expected age, and no exhibition of sex tendencies thereafter.
EFFECTS OF FEEDING THYROID
How subtly the internal secretion affects every phase and aspect of child as well as adult, by doing something to the speed of activities in their cells, is told straightway by the effects of it when eaten or introduced into the skin or blood of various people. A cretin, idiotic, dwarfish, deformed, hopeless, an incessantly prodding burden of sorrow to the mother, who looks upon the masterpiece she had labored to bring forth, and beholds a terrible gargoyle, becomes transformed when fed thyroid.
In a few days the cretin will get warmer, and require much less wrapping and bed-clothing. With the improvement in circulation, the color becomes better and the extremities lose their coldness. In a week or so, irritability and resentment at disturbance appear. He will begin to recognize and know his parents, smile and play. There is a gradual return to the normal of the facial appearance, and a resumption of growth. All kinds of marvelous growth effects occur. Twenty teeth may be cut in six months. Coarse, rough dry, shaggy hair becomes fine, silken, long and curly. The skin becomes soft, moist and roseate. Inches in height may be added every month. Bright, active, even talkative, are the descriptive terms an observer would apply after a few months. A complete remaking of body and soul is apparently affected.