Daily life of farming and supporting a family on the ancient Loess Plateau

Gaixia's husband also said that they didn't know goiter was a disease at first, because it was only when people in the village started to get it, and no one knew that it could affect the next generation.

Moreover, although their village was not wealthy at the time, it was far from the city, so there was less exploitation by officials and less banditry, which made many families outside willing to marry their daughters into the village.

Perhaps because of the young women who married into the family, the babies born at that time were all normal.

Later, people gradually discovered that every year, several children in the village were born with abnormal minds, considered mentally challenged. Although every village has one or two slightly abnormal children, it seemed that there were far too many in their village.

From that time on, it became difficult for them to find wives from outside the village. In order to marry off their sons, the elders had to save money and buy slave women from wealthy families. Gaixia was one such woman they bought.

At the time, the villagers believed that it must be because of bad feng shui in their village that so many children were born. So every year they spent money to hire a feng shui master to fix it, but it didn't seem to help much.

Later, a lost young doctor came to the village.

The doctor, surnamed He, entered the village and, seeing so many people with goiter, as well as so many mentally challenged children and young people, immediately realized that the goiter in their village was a disease. Moreover, Doctor He deduced that it was this disease that caused the women to give birth to mentally challenged children.

It was then that they learned that goiter was a disease, and a very serious one at that.

That Dr. He was very kind-hearted. Ever since he discovered the goiter in their village, he would come to their village several times a year to deliver medicine and help them find the root cause of the disease.

Many years passed, but Dr. He still couldn't find the cause of their enlarged necks. It wasn't until the young Dr. He became the old Dr. He that he discovered the goiter in their Guazi Village might be related to the water the villagers drank.

Because there used to be a river flowing through their village, but after a series of droughts and little rain, the river dried up and stopped flowing completely, so the villagers could only drink water stored in cisterns all year round.

Based on decades of observation and analysis, Dr. He believes that the water cellars in their village were not built as airtight as wells on the plateau, resulting in many micro-insects in the water during the spring, likely generated from fallen willow catkins. The water is cold and damp, and combined with the presence of these micro-insects, drinking it easily leads to goiter.

However, they later rebuilt the water cellars using the same method as those built on the plateau, and they kept them very well sealed. In addition, the village also dug a well, and everyone used well water for cooking and water from the cellar for washing clothes.

But the goiter just wouldn't get better, and there were more and more silly kids in the village.

Hearing this, Ji Yongling sincerely admired Dr. He. To have such insight into goiter, without the knowledge of modern medicine, was truly remarkable. It was completely ahead of its time, approaching the very edge of modern medicine.

After all, we can't judge today's medical standards by hindsight. Even in the future, there will still be so many diseases that leave us helpless. Humanity's understanding of disease must be based on science, technology, and social development.

This type of endemic goiter is a local disease, mainly occurring in high-altitude and semi-mountainous areas far from the coast, primarily caused by iodine deficiency. Iodine cannot be synthesized in the human body and must be obtained from nature. If the environment is iodine deficient, then the people living there will naturally also be iodine deficient.

Endemic diseases typically have three causes.

One cause is a deficiency or excess of a certain element or compound in the water and soil of the affected area, leading to illness in humans due to excessive or insufficient intake of food and water. Endemic goiter falls into this category.

Second, the disease occurs in areas where a certain pathogen and reservoir host naturally exist. Humans become infected through contact with diseased animals or vectors carrying the pathogen, such as schistosomiasis that ravages the Yangtze River basin.

Thirdly, there are lifestyles specific to the affected areas. For example, in some parts of Southwest China, there is a habit of burning high-fluoride coal indoors. The fluoride in the coal pollutes the indoor air through combustion, which in turn contaminates the food stored indoors. People can become poisoned by ingesting this air and food with excessive fluoride over a long period of time.

Therefore, throughout history, human health has been far more dependent on the environment than we imagine. It's just that sometimes we don't realize it.

Based on Gaixia's description, Ji Yongling speculated that in the years since the river flowing through Guazi Village dried up, the surface water in their area had suffered severe iodine loss, but without any external replenishment, resulting in iodine deficiency.

From a natural geographical perspective, Guazi Village is located in a deep valley within a deep mountain valley. The climate is dry with little rainfall, low vegetation coverage, and severe soil erosion, resulting in a large loss of iodine from surface water.

In the 1970s and 80s, there were many similar villages with goiter. Later, the country promoted the use of iodized salt for prevention, and the disease gradually decreased.

Besides the loss of iodine from surface water, Ji Yongling also wanted to investigate whether other factors were contributing to the iodine deficiency in Guazi Village. This is because many diseases are often caused by multiple factors, and sometimes controlling only one factor may not be effective.

Therefore, Ji Yongling and Ji Manqing stayed at Gaixia's house for two days. They wandered around Guazi Village, and during this wandering, Ji Yongling actually discovered another hidden problem.