1883

Theodor Kocher presents his evidence on specific cause of cretinism to congress of the German Surgical Association: He discovered that some time after thyroidectomy his patients lost their physical strength and intelligence, showing symptoms like swollen hands and feet, puffy face, and anemia. These changes were even more marked in children, who reminded Kocher of cretins. Kocher claimed removal of thyroid induced these side-effects, and proposed a close relationship between cretinism and thyroid gland. His organ concept of cretinism provided a new focus for research, i.e., the internal secretion of the thyroid gland, and illustrates “the close affinity of surgery and experimental physiology. . . . The ability to provoke and reverse cretinous symptoms independent of place was also the crucial argument against the still-prevailing view that cretinism was endemically caused”(Schlich I, 433-435). . . . In his article of 1892, Kocher held that “The crucial criterion for the attribution of cases to cretinism was now the resemblance of their clinical picture with the effects Kocher had observed after total thyroidectomy, his ‘cachexia strumpiva.’ All those cretins who did not look like Kocher’s artificial cretins were no longer cretins, for example, some deaf-mutes (436). . . What Kocher presented here was the cause of a new cretinism, a cretinism that was defined according to the effects of surgery” (437).