Hypothyroidism occurs in two main forms-cretinism in children, myxoedema in adults. Both conditions are due to simple insufficiency of the thyroid gland. Only the sporadic form of cretinism will be discussed in this articie as the endemic variety is not a result of simple thyroid deficiency. Its aetiology is intimately associated with endemic goitre, and it occui-s in the later generations of families suffering from endemic goitre. The pathogenesis of endemic cretinism cannot be regarded as one

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... of simple hypothyroidism. Sporadic cretinism is found in regions where goitre is not endemic and bears little relation to the endemic variety. It is said that heredity is seldom a factor, and this is certainly true in my experience. The picture is typical of simple athyroidism. This may be attributable occasionally to thyroid maldevelopment but usually to atrophic changes in the foetal gland resulting from acute thyroiditis, probably the sequel of infective disease in the mother during pregnancy.