The number of these unfortunate beings in the mountainous districts of Europe, and especially of Central and Southern Europe, is very great.  In several of the Swiss cantons they form from four to five per cent of the population.  In 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 moral condition.