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The shocking, forgotten history of cretinism
Now an insult, 'cretin' was the medical term for a debilitating disease endemic in the Alps until the early 20th century.
- Until about a century ago, 'cretinism' was endemic throughout large parts of the Alps.
- Sufferers often had a visibly enlarged thyroid gland, and in the worst cases were severely retarded.
- Although 'goiter belts' in North America and Europe have been eradicated, the disease remains common throughout the world.
Cretins with goiter, Styria (Austria), early 19th century.
Image: Oesterreichs Tibur (1819), public domain. Found here on Wikimedia Commons.
How do you make Captain Haddock swear like the drunken sailor he is, without R-rating the comic that stars his much milder-mannered friend Tintin?
Eventually Hergé, Tintin's spiritual father, found the answer. Whenever Haddock verbally exploded, his stream of invective was colorful rather than off-color. The captain merely shouted scientific and esoteric terms at the victims of his frequent displeasure.
So when Haddock let out "crétin des Alpes" ('Alpine cretin') in the original French-language version of The Seven Crystal Balls (serialised from 1943), the expression was sufficiently obscure to be inoffensive, its topographic specificity only adding to the humorous effect (1).
Yet the word 'cretin' has a very real, very shocking and at that time still very recent history, and indeed a link to the Alps. When Haddock used the term, the age-old blight of cretinism had been erased only a few decades earlier. But the relative isolation of the sufferers, and the pitiful nature of their suffering, had already wiped the disease from public memory.
Map of the geographic distribution of 'cretinism and idiocy in France'. White: less than 2 'cretins or idiots' per 1,000 inhabitants. Lightest grey: at least two. Middle shade: at least three. Darkest grey: at least five.
Image from p. 96 of the report on goiters and cretins by Dr Jules Baillarger (1873), public domain. Found here on the page Culture, Histoire et Patrimoine de Passy.
From the 18th century onwards, travellers exploring the then remote Alps for their natural beauty were often horrified by the region's human geography. Among the inhabitants of some secluded valleys, they found many who suffered from physical deformities and mental retardation.
In the Guide du Voyageur en Suisse (1788), Thomas Martyn observed: "These imbeciles, known as 'cretins', are plentiful (in the Valais region of Switzerland). Their body resembles that of a dwarf, they appear misshapen and sombre, their minds are devoid of all activity. Their smile only indicates that the cretin is merely a living animal."
The most prominent physical symptom was a so-called 'goiter' (2) – a greatly enlarged thyroid gland, bulging forward from the neck. Other physical symptoms included dwarfism (with adult sufferers as short as 1 meter (3 ft 3 in), loss of hair, thick skin, enlarged tongue and/or belly, and muscle impairment sometimes severe enough to prevent walking or even standing.
Additionally, cretinism could manifest as cognitive impairment, from slight to severe mental retardation. Some sufferers were so afflicted they couldn't speak or take basic care of themselves.
'Joseph le crétin': photograph by Eugene Trutat (1840-1910).
Image preserved by the Muséum de Toulouse public domain. Found here at Wikimedia Commons.
Although not yet by that name, 'cretinism' was known to the ancients and was described by Roman writers. However, because its most severe manifestations were limited to isolated mountainous regions, it was long underreported – and misdiagnosed. Early medical hypotheses blamed stagnant valley air, bad water, 'geological toxicity,' or inbreeding for the congenital disorder.
The actual cause of cretinism is iodine deficiency, which is why the current preferred term is 'congenital iodine deficiency syndrome' or CIDS. Iodine is a mineral that is needed for the production of thyroid hormones, without which the human body's metabolism can't properly function.
Iodine is most abundantly present in the oceans and is transported to land by rain. However, it is not uniformly present in soil. It is most notably absent from mountainous and other inland regions, especially those subject to frequent flooding.
Plants grown in these regions will also be iodine-deficient, and will locals eating only locally-sourced foods. The soil in some Alpine regions is severely iodine deficient. In combination with dietary monoculture, this explains the abundance of cretinism in the region.
Geographic distribution of goiters throughout Europe in 1883: not just in the Alps or Pyrenees, but also notably throughout western Germany, northern Italy, Austria and Britain.
Image: Bircher (1883), public domain. Found here on the page Culture, Histoire et Patrimoine de Passy.
From the 18th century, 'cretinism' became the common term for the disease in French medical texts. The word's origin is uncertain but may derive from the French 'chrétien' ('Christian'), a common greeting in the French Alps – or perhaps a term used as a reminder of the basic humanity of the sufferers. Other possible etymologies:
- 'creta', Latin for 'chalk', because of the sufferers' pale appearance;
- 'cretira', a local word for 'creature'; or
- 'cretine', a French word for soil deposited by flowing water, based on the assumption that poor soil caused the disease.
Around 1850, the French state identified around 20,000 of its citizens as 'cretins' and around 100,000 as sufferers from the goiter, in 24 of its around 90 departments – especially in its mountainous regions, in both the Alps and Pyrenees.
In the 19th century, so-called 'goiter belts' were identified in Europe and North America: regions where the most visible symptom of cretinism was relatively common – even if the severity of the illness was usually much less than in the worst-afflicted parts of the Alps.
Originally a neutral term, 'cretin' fell out of use as an official medical term (in both English and French) in the early 20th century due to pejoration, i.e. the downgrading of a word's meaning (3), and its use is now shunned.
Map showing the relationship between iodine deficiencies (grey) and goiter occurrence (shaded) in the United States. Date unknown - probably early 20th century.
Image: Armed Forces Institute of Pathology, public domain. Found here at JC Durbant.
With the growth of trade in the 19th century, the dependence on locally grown produce throughout Europe diminished, greatly reducing the occurrence of the disease. Around that time, Swiss doctors were the first to propose iodine deficiency as the genuine cause of cretinism. However, it took three generations for this theory to be proven – if action had been taken immediately, about 50,000 sufferers would have been saved the disorder's debilitating effects.
From 1922, Switzerland began to distribute iodised cooking salt, as well as iodised lozenges for children. Almost immediately, new cases of cretinism ceased to occur. At present, more than 120 countries have mandatory programs for adding iodine to food staples (typically salt, but also flour, rice or oil).
In developed countries, cretinism has almost completely been wiped out, thanks to standard screening for thyroid function on newborn babies. Iodine deficiency is still a sufficiently serious problem to remain the most common preventable cause of brain damage in new-borns and young children today. If the condition is found, its symptoms can be suppressed by lifelong administration of thyroxine.
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(1) Haddock later recycles the insult in other geographic contexts: "crétin de l'Himalaya" (Tintin in Tibet) and "crétin des Balkans" (The Calculus Affair).
(2) Derived via Provençal and French from the Latin gutturus, 'throat'.
(3) A similar process occurred with 'lunatic' and 'spastic', no longer neutral descriptors, now adjectives with a decidedly negative connotation.
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Can an orgasm a day really keep the doctor away?
- Achieving orgasm through masturbation provides a rush of feel-good hormones (such as dopamine, serotonin and oxytocin) and can re-balance our levels of cortisol (a stress-inducing hormone). This helps our immune system function at a higher level.
- The surge in "feel-good" hormones also promotes a more relaxed and calm state of being, making it easier to achieve restful sleep, which is a critical part in maintaining a high-functioning immune system.
- Just as bad habits can slow your immune system, positive habits (such as a healthy sleep schedule and active sex life) can help boost your immune system which can prevent you from becoming sick.
How masturbation affects your brain...<p>Orgasms are a very common human phenomenon. The physical and mental health benefits have been researched frequently as a result, and yet, there is still so much to be learned about how our bodies and brains react to the chemicals and hormones released during and after experiencing this type of sexual release.</p><p>"The amount of speculation versus actual data on both the function and value of orgasm is remarkable" explains Julia Heiman, director of the <a href="https://kinseyinstitute.org/" target="_blank">Kinsey Institute for Research in Sex, Gender, and Reproduction</a>.</p><p>Masturbation causes a rush of <a href="https://www.webmd.com/mental-health/what-is-dopamine" target="_blank">dopamine</a>, which is a chemical that is associated with our ability to feel pleasure. Along with the rush of dopamine that is released during an orgasm, there is also a release of a hormone called <a href="https://www.livescience.com/42198-what-is-oxytocin.html" target="_blank">oxytocin</a>, which is commonly referred to as the "love hormone."<br></p><p>This concoction of chemicals does more than just boost our mood, it also can play a key role in decreasing stress and promoting relaxation. Oxytocin decreases <a href="https://www.webmd.com/a-to-z-guides/what-is-cortisol" target="_blank">cortisol</a>, which is a stress hormone that is usually present (in high volumes) during times of anxiety, fear, panic, or distress. </p><p>According to BDSM and fetish researcher <a href="https://www.psychologytoday.com/us/therapists/dr-gloria-brame-colbert-ga/278388" target="_blank">Dr. Gloria Brame</a>, an orgasm is the biggest non-drug induced blast of dopamine that we can experience. </p><p>By boosting the oxytocin and dopamine levels and subsequently decreasing our cortisol levels, the brain is placed in a more relaxed, euphoric, and calm state. </p>
Masturbation boosts your immune system and raises your white blood cell count.<p>How do those effects on the brain from reaching orgasm translate to boosting our immune system and making our body healthier?</p><p>The increase of oxytocin and dopamine that causes a decrease in cortisol levels can help boost our immune system because cortisol (well-known for being a stress-inducing hormone) actually helps maintain your immune system if released in small doses. </p><p>According to <a href="https://www.health24.com/Sex/Great-sex/incredible-health-benefits-to-masturbating-20181030-2" target="_blank">Dr. Jennifer Landa</a>, a hormone-therapy specialist, masturbation can produce the right kind of environment for a strengthened immune system to thrive. </p><p><a href="https://www.ncbi.nlm.nih.gov/pubmed/15316239" target="_blank">A study</a> conducted by the Department of Medical Psychology at the University Clinic of Essen (in Germany) showed similar results. A group of 11 volunteers were asked to participate in a study that would look at the effects of orgasm through masturbation on the white blood cell count and immune system.</p><p>During this experiment, the white blood cell count of each participant was analyzed through measures that were taken 5 minutes before and 45 minutes after reaching a self-induced orgasm. </p><p>The results confirmed that sexual arousal and orgasm increased the number of white blood cells, particularly the natural killer cells that help fight off infections. </p><p>The findings confirm that our immune system is positively affected by sexual arousal and self-induced orgasm and promote even more research into the positive impacts of sexual arousal and orgasm. </p>
Masturbation can ease and prevent pain, which allows you to achieve the restful sleep that helps your immune system stay strong and healthy.<p>The benefits of masturbation have long been debated, but the more research that is done on the topic the more we understand that there are many positive reactions that happen in our bodies and brains when we orgasm.</p><p>Orgasms can help prevent or mitigate pain, which boosts the immune system, preventing cold and flu symptoms. </p><p>According to neurologist and headache specialist Stefan Evers, about one in three patients experience relief from migraine attacks by experiencing sexual activity or orgasm. Evers and his team <a href="https://www.livescience.com/27642-sex-relieves-migraine-pain.html" target="_blank">conducted an experiment</a> with 800 migraine patients and 200 patients who suffered from cluster-headaches to see how their experiences with sexual activity impacted their pain levels. </p><p>The study showed that 60% of migraine sufferers experienced pain relief after participating in sexual activity that resulted in orgasm. Of the cluster-headache sufferers, about 50% said their headaches actually worsened after sexual arousal and orgasm. </p><p>Evers suggested in his findings that the people who did not experience pain relief from migraines of headaches during their sexual activity did not release as large amounts of endorphins as those who did experience pain relief. </p><p>According to <a href="https://www.sharecare.com/health/chronic-pain/chronic-pain-affect-immune-system" target="_blank">rheumatologist Dr. Harris McIlwain</a>, people who suffer from chronic pain have immune systems that are simply not functioning at full capacity - therefore, alleviating pain (through orgasm, as an example) can help boost the immune system. </p><p>Orgasms can also promote relaxation and make it easier to fall asleep. Serotonin, oxytocin, and norepinephrine are all hormones that are released during sexual arousal and orgasm, and all three are known for counteracting stress hormones and promoting relaxation, which makes it much easier for you to fall asleep.</p><p>There are <a href="https://www.ncbi.nlm.nih.gov/pubmed/1233384" target="_blank">several studies</a> showing that serotonin and norepinephrine help our body cycle through REM and deep non-REM sleeping cycles. During these sleep cycles, the immune system releases proteins called <a href="https://www.sleepfoundation.org/articles/how-sleep-affects-your-immunity" target="_blank"><span id="selection-marker-1" class="redactor-selection-marker"></span>cytokines<span id="selection-marker-2" class="redactor-selection-marker"></span></a>, which target infection and inflammation. This is a critical part of our immune response. Cytokines are both produced and released throughout our bodies while we sleep, which proves the importance of a good sleep schedule to a healthy immune system.</p>
Masturbation promotes a high-functioning immune system; a healthy immune system prevents cold and flu.<p>The immune system is a balanced network of cells and organs that work together to defend you against infections and diseases by stopped threats like bacteria and viruses from entering your system. While there are many things we need to do to keep our immune systems functioning at optimal levels, masturbation (or other means of achieving orgasm) has proven to have positive effects on the immune system as a whole.</p><p>Just as bad habits (such as an inconsistent sleep schedule or harmful chemicals in your body) can slow your immune system, positive habits (such as a healthy sleep schedule and active sex life) can help boost your immune system. </p>
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A new study suggests that an old tuberculosis vaccine may reduce the severity of coronavirus cases.
- A new study finds a country's tuberculosis BCG vaccination is linked to its COVID-19 mortality rate.
- More BCG vaccinations is connected to fewer severe coronavirus cases in a country.
- The study is preliminary and more research is needed to support the findings.
Professor Luis Escobar.
Credit: Virginia Tech