478 CRETINS CREUZER well as in some of the more level regions, they are found in great numbers. The goitre or bronchocele, so prevalent throughout the whole of the Alpine countries, is often accompanied by cretinism, and is, with very few exceptions, always found on the cretin. Switzerland, and especially the cantons Valais, Vaud, Uri, Aar- gau, Grisons, and Glarus, seem to be the home of this frightful deformity. It is endemic in portions of Rhenish Prussia, Baden, Piedmont, Bavaria, Upper Austria, Wtirtemberg, Denmark, Norway, in the Alpine departments of France, in portions of Turkey and Russia, and in the highlands of Scotland. In Africa it has been found prevalent along the northern slope of the Atlas range. In Asia, the districts around the base of the Himalaya range furnish great num- bers of cases, as well as China, Chinese Tar- tary, and Sumatra. In South America, cretins are found in considerable numbers on the east- ern or Atlantic slope of the Andes ; and scat- tered cases occur along the Alleghany, Green mountain, and Hoosac ranges in the United States. In some parts of Canada cases have also been observed. The number of cretins in the sub- Alpine districts of Europe, whether considered actually or relatively to the popu- lation, is frightfully large. In some localities in Switzerland, Rhenish Prussia, and the Al- pine districts of France and Savoy, there are whole villages in which not an able-bodied man can be found. The causes of cretinism are involved in some obscurity, though many of the ablest medical men in Europe have in- vestigated the subject with great care. The localities in which it is most prevalent in the Alpine districts are low-lying valleys, narrow, and exposed to the direct rays of the sun but for a few hours each day, and usually having but one outlet. In these, the air is often stag- nant and the heat intense ; the water is also in some cases charged with mineral impurities, es- pecially the salts of lime ; the food of the inhabi- tants is often scanty in quantity, and inferior in quality ; they are in many cases grossly intem- perate, and intermarriage with near relatives, and those affected with goitre or incipient cre- tinism, is common. In some countries it occurs on open plains, but in other respects under cir- cumstances analogous to those already named. The life of the cretin is usually short ; few are found above 30 years of age, and any treatment having in view the improvement of their health must, to be of benefit, be applied to the young. The recovery of a patient beyond the age of 12 years is almost hopeless. The first thing to be accomplished is the removal of the young cre- tin, as soon as possible after the di'sease exhib- its itself, to a pure bracing atmosphere. It has been ascertained that on the Alps the disease seldom occurs at an elevation of 3,000 ft. above the level of the sea, and never at the height of 4,000 ft. Hence, those who have attempted its treatment in Europe have preferred elevated locations. The treatment requires an abun- dance of pure water, for drinking, washing, and bathing; warm and cold baths and douches; friction of the skin with brushes and stimula- ting liquids, to rouse its action ; warm clothing ; gymnastic exercises ; mineral tonics ; nourish- ing food ; iodine, cod-liver oil, and phosphates. Galvanism and electro-magnetism are also of benefit. The effort to develop the mind must follow the attempt to restore the body to a healthy condition. The method of training for this purpose is similar to that employed in the instruction of idiots. In 1839 Dr. Guggenbiihl made the first systematic effort to treat cretin- ism. He opened an establishment at Abend- berg, near Interlaken, in Switzerland, and treated the disease with some success. After his death his institution was abandoned. A few similar institutions have been established in Europe, and some schools for idiots also admit cretins ; but the provisions for this pur- pose are far from adequate. A few years ago it was estimated that there were in Europe 50,000 cretins, while the institutions for their benefit had accommodation for only 250. CREUSE, a central department of France, bordering on the departments of Indre, Cher, Allier, Puy-de-D6me, Correze, and Haute- Vienne; area, 2,151 sq. m. ; pop. in 1872, 274,663. It was formed from parts of the old provinces of Berry and Limousin, with the whole of Haute-Marche, and is traversed by the river Creuse, a tributary of the Vienne, from which it derives its name, and by other streams, none of which are here navigable. It is very mountainous, and contains granite, coal, gypsum, and potters' clay. The soil is poor, except in the N. E. part ; agriculture is back- ward; the climate is damp and changeable; and the domestic animals are of an inferior breed. The crops of grain are insufficient for domestic consumption. Fruit, rape seed, and hemp, however, are raised abundantly, and quantities of honey are collected. The chief manufactures are carpets, tapestry, coarse wool- len goods, cotton, leather, paper, glass, and porcelain. The department is divided into the arrondissements of Gueret, Bourganeuf, Bous- sac, and Aubusson. Capital, Gueret. CREUTZ, Gustaf Filip, count, a Swedish poet and diplomatist, born in Finland about 1726, died in 1785. While Swedish ambassador to Paris, IIQ concluded, April 3, 1783, a commer- cial treaty with Benjamin Franklin, as repre- sentative of the United States. On his return to Stockholm he was appointed minister of for- eign affairs and chancellor of the university of Upsal. Gustavus III. purchased his library, which is now in the palace of Haga ; and on April 26, 1786, the king in person pronounced his eulogy before a chapter of the Swedish order of the seraphim, of which Creutz was a member. His poems were published in 1795, including Atis og Camilla, a pastoral epic. CREUZER, Georg Friedrich, a German philolo- gist and antiquary, born at Marburg, March 10, 1771, died in Heidelberg, Feb. 16, 1858. He was the son of a bookbinder, commenced his
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