Some clinical aspects of simple goitre in children with special reference to the chalk valleys of Wilts.

(1) In this area, there is evidence to show that goitre incidence in children is associated with water supplies from cretaceous formations. (2) These water supplies contain in suspension mineral matter of a calcareous nature. (3) There is no evidence in this area to show that contaminated water supply is a factor in the causation of goitre. (4) The class of child liable to attack With goitre is the mal- nourished child of the agricultural worker. (5) This subnórmal nutrition is due to a deficient dietary lacking in vitamines. (6) Simple goitre in early life increases the numbers of "dull and backward" children. (7) The goitrous child is often handicapped in later life on account of his liability to disease and lowered mentality. (8) If malnutrition were prevented or treated in the pre- school period, the number of goitrous children would be small. The rural worker should be instructed in a more suitable dietary for his children. (9) That treatment of malnutrition in early goitre is of primary importance. (10) Diseased tonsils herald the onset of goitre, and tonsillectomy is harmful in these cases. (11) Iodine is definitely curative of such diseased tonsils and early goitres, provided malnutrition, if present, is treated at the same time