Schlapp : Causes of Defective Children 



397 



To illustrate this point, let us glance 

 at Figure 4. Here is a child which 

 was brought to me at the age of four 

 years. It has been treated elsewhere 

 for obesity, with the result of harm, 

 instead of help. The thyroid gland is 

 most seriously involved in this unfor- 

 tunate. Photograph A shows the child 

 as it appeared when brought to my 

 clinic. Photograph B shows the same 

 child after six weeks of treatment This 

 child will be considerably helped, but 

 there is no hope of normalizing it. The 

 four first years, during which its brain, 

 bones, and hair failed to form properly, 

 cannot be recaptured from the past. 



My intention, in this article, has been 

 to contrast such feats of treatment as 

 are now within our power, with the in- 

 finite mysteries still to be explored. It 

 is clear beyond peradventure — or so it 

 seems to me — that to disturbances of 

 the chemical balance in the blood of 

 mothers we will be able to trace far 

 the greatest number of all cases of 

 physical and mental malformation in 

 children. It is even possible that more 

 extensive investigations will widen the 

 horizons in this field, and that we shall 

 find this disturbance in the body of the 

 mother directly responsible for faults 

 and weaknesses in the child, whose 

 connection with such disturbance has 

 as yet been unsuspected. 



The problem which stands immedi- 

 ately before us. however, is to gain 

 such understanding of other gland in- 

 volvements in children as we now pos- 

 sess in the matter of thyroid cases. We 

 know full well that the pituitary gland 

 is involved in certain of these pitiful 

 malformations of human beings. We 

 know, less certainly, that the supra- 

 renals, the pineal, the interstitials and 

 the thymus also play their parts. But 

 to date we have not been able to deter- 

 mine the precise nature of their influ- 

 ence or of the disturbances to which 



they are liable. Still worse, in cases 

 where we have been able to guess at 

 the involvement of these other endo- 

 crines. we have been unable to treat 

 the condition effectively. The task 

 which confronts us, therefore, is to ex- 

 plore both the nature of the disorders 

 due to the derangement of other 

 glands, and the manner of administer- 

 ing the missing hormone substances. 

 As yet we can do the latter with full 

 success only in thyroid cases. 



It seems to me that our total ener- 

 gies ought to be brought to this work 

 of research, in the laboratory and in 

 the clinic. We must lay less stress 

 upon devising mentality tests and the 

 like, which deal merely with the symp- 

 tomatology of the subject; and we 

 must devote ourselves whole-heartedly 

 to the quest after the etiology of these 

 terrible and grotesque afflictions. Such 

 tests are of unquestioned value in the 

 diagnosis and classification of mental; 

 abnormalities, but to look to them for' 

 light upon the prevention and treatment 

 of these conditions would be to place 

 ourselves in the position of general 

 medicine in the middle of the last cen- 

 tury when symptoms, instead of 

 causes, were being treated — and with 

 what lamentable results ! It is obvious 

 that no amount of education of func- 

 tion can remedy ills dependent upon 

 malformation of the essential machin- 

 ery of the human mind ; neither can it 

 supply any of the missing chemicals 

 which furnish the necessary food for 

 this machinery. 



The way lies straight, it seems to me. 

 We know the general causes of most 

 defectiveness and malformity. Our 

 duty is to search out the specific causes 

 for each form known to medicine. 

 Once this etiology is in hand it will be ' 

 but a step to devise practical methods 

 of operation. 



