Same case.
AFTER TREATMENT WITH THYROID EXTRACT.

From "Sporadic Cretinism in America," by Sir William Osler, Bart.,
M.D, F.R.S. Transactions of the Fourth Congress of American
Physicians and Surgeons, New Haven, 1897.

fectly well. And she stays well. Here, for instance, is an illustration (producing a set of photographs) of what may be done in eleven months. Here is a typical little cretin child, between two and nearly three years of age, unable to walk, unable to talk, with a pot-belly and prominent navel, with no sign whatever of intelligence about its face; in fact, showing the typical apathetic, dull condition that characterises these cases. And here you see the successive changes in that child in the course of eleven months. You see I have marked it here, after two months' treatment, after three months, after five months, after seven months, and at eleven months (handing round the photographs). That is practically a miracle. That child was doomed to hopeless imbecility. And I have had a whole series of such cases eighteen or twenty in all.

"What I feel, of course, is that such a thing as that, such a transformation as that which I have shown to you, is such a tremendous gain to humanity-just think what it must be to an individual who had a child in that condition that it is impossible to put against it the lives of a certain number of dogs sacrificed. I do not think that the two can be weighed together. And when you think that that has been done in hundreds and hundreds of cases, and will be done, and that these people remain well, I think it is one of the strongest evidences in favour of the benefits which have been derived from experiments on animals that we can possibly have."

In reply to further questions, Professor Osler agreed that the association between cretinism and absence of the thyroid gland had been observed long before Sir Victor Horsley's experiments were made. "The disease of myxœdema was well known, and cretinism was well known; but there was no suggestion that it could be treated, until the results of Sir Victor Horsley's work were known.”

The Work of Pasteur and Lister

Later, the following questions were put and answered: Q. We were told by a witness the other day, who has had considerable surgical experience, that Listerism is now broken down and discredited.-A. Where did you produce that gentleman from-Hanwell?

Q. I will not mention his hospital, but he said that the antiseptic treatment had been absolutely discarded, and that the aseptic treatment was a reversion to the old preListerian days.-A. It is the difference between tweedledum and tweedledee. They are both applications of the same principle.

Q. There being a slight difference in the one, due to increased knowledge?-A. Yes; it does not make any real difference.

Q. The witness also denied that the bacilli or protozoa which are found in inseparable connection with certain diseases have any causative effect; and he put his view rather strikingly. He said you might as well say that trout or salmon in a river were the cause of the river, as that the bacilli or protozoa were the cause of, say, Malta fever, or malaria, or sleeping sickness. Perhaps I might read you some words of his ?-A. I think you might spare me. I decline to listen to twaddle of that sort. I would not answer a question of that kind. It is not the opinion of any man whose opinion is worth listening to, who has paid any attention to the subject, who has studied the subject, and who knows the conditions as they exist.

Q. Does his opinion represent anything of what might be called a school of medical thought?-A. Not at all.

Q. Or is it a merely individual eccentricity?-4. It represents the school of the back numbers.