years of age) is now seventeen years old, and is 4 ft. 1 in. in height. Another, a boy, is eight years old, and is 2 ft. 7 in. high. A third, about twenty years old, is 2 ft. 4 in. high; this is a boy or man. The remaining patient, a girl, is twelve years old, and 3 ft. 10 in. in height.

The author is disposed to adopt Mr. Curling's opinion that the atrophy of the thyroid body (if this should turn out to be a constant feature in sporadic cretinism) is the cause of the other phenomena of the disease; and in the concluding part of the paper, an hypothesis is advanced, which may perhaps explain the apparent contradiction which is involved in the association of this affection with the wasting of the thyroid body, while the other form of cretinism is connected with goitre. At the same time it is thought that this hypothesis affords an explanation of certain peculiarities in the relations between endemic cretinism and goitre, which have hitherto appeared to be difficult of comprehension. Goitre is endemic in many parts of England, where cretinism is unknown. Goitre is the earlier effect of the endemic influence; cretinism shows itself when that influence has been intensified by operating on more than one generation. Hence it might be inferred that the worst cretins would invariably have very large goitres. Such, however, is not the case; they have often no enlargements of the thyroid body. These considerations have led some observers to think that the association of endemic goitre with endemic cretinism is a mere accident. They rather appear to prove that there is a certain antagonism between the two phenomena. A large goitre may possibly have the power of protecting the individual against the more severe effects of the endemic influence. The most careful investigation has failed to show, either in the air, the water, or the soil of Alpine valleys, the presence of any element which is absent where cretinism does not prevail. Hence, if one could discover any counteracting tendency, it would not be improbable that the cause of cretinism prevails much more widely than the disease itself, although doubtless with an intensity varying in different localities. The author thinks that to counteract this cause in its slighter degree may be one of the functions of the healthy thyroid body, which may thus be supposed to perform under ordinary circumstances the same office which the organ hypertrophied to form a goitre is

imagined by him to carry out in those districts where cretinism is endemic. If this be so, one can see why wasting of the thyroid body should in England produce a form of cretinism.

ANNUAL MEETING.

Wednesday, March 1, 1871.
At 8 o'clock p.m.

GEORGE BURROWS, M.D., F.R.S., President, in the Chair.

Present-39 Fellows.

The President, on taking the chair, declared the Ballot for the election of Officers and Council for the ensuing year open for one hour, nominating Dr. Horace Dobell and Mr. Alfred Willett Scrutineers.

The Auditors' Report on the Income and Expenditure of the Society for the year 1870 was read, as follows:

[See page 332.*]

It was moved by Dr. Webster, and seconded by Dr. Greenhow, and carried:

"That the Audited Abstract of the Income and Expenditure of the Society, now read, be received, adopted, and circulated among the Fellows."

The Report of the President and Council was then read, as follows:

The President and Council have to congratulate the Society that, notwithstanding the losses the Society has sustained by deaths, the number of the Fellows remains undiminished, and is now rather

above the average, being at the present time 665. The new elections have been about the average of the last twenty years, slightly in excess of those of last year, but below those of the years 1867 and 1868. Sixteen new Fellows have been elected,

of whom one half were non-resident.

The deaths have been fifteen in number, and have occurred principally among the non-resident Fellows.

Five resident Fellows have become non-resident, and three have resigned.

The income of the Society for the year ending December 31st, 1870, amounted to £1421 18s. Od., exceeding that of the previous year by £30; while the expenditure has been £40 less, giving a difference of £70 in favour of the past year, and leaving a balance in hand of £537 6s. 5d.

The number of annual subscriptions received has been 301, a larger number than in any year since the foundation of the Society, with the exception of the years 1853, 1854, when they were 304 and 305 respectively.

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