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"There is one disease," wrote James Pilkington in 1789, "to which the inhabitants of Derbyshire are so much subject, that it has taken its name from its great prevalence in this situation."

Derbyshire Neck, also called Goitre, is a swelling of the thyroid gland and is now known to be caused by lack of iodine. It is almost unknown today because iodine is added to drinking water. In the eighteenth century no-one knew for sure what caused it. Some thought it was hereditary in particular families, others that it was caused by living "on the bleak sides of hills." They all agreed that women, particularly "child-bearing poor women" were the main victims of "this very unfortunate female disease."

In the year 1769 Mr Prosser published the following description of this disorder:

‘The Bronchocele, or Derby Neck, is a tumor arising on the fore-part of the neck. It generally first appears sometime betwixt the age of eight and twelve years, and continues gradually to increase for three, four, or five years; and often the last half-year of this time, it grows more than it had for a year or two before. It generally occupies the whole front of the neck, as the whole thyroid gland is here generally enlarged, but is rather in a pendulous form, not unlike the flap or dew-cap of a turkey cock’s neck, the bottom being generally the bigger part of the tumour, and going gradually less upwards. It is soft, or rather flabby to the touch, and moveable; but when it has continued some years after the time of its growing, it gets more firm and confined.

‘By the situation and nature of the complaint, it occasions a difficult breathing, and very much so upon the patient’s taking cold, or attempting to run or walk fast. In some the tumour is so large, and so much affects their breathing, as to occasion a loud wheezing. It very rarely happens to boys, indeed I have never been able to make out one instance of it, in a man or boy.

‘It is very common in many counties in England, Derbyshire especially, where from its frequency it has the name of Derby Neck, and some other countries are almost free from it.

Taken from A View of the present state of Derbyshire. By J. Pilkington. 1789.