SPORADIC CRETINISM 



125 





Leucocytes, 6800, of which: 

 Polymorphonuclear neutrophiles, 48.4 per cent. 

 Large mononuclears, 8.3 per cent. 

 Lymphocytes, 40 per cent. 

 Eosinophiles, 3.3 per cent. 

 Nov. ii. Erythrocytes, 5,250,000. 

 Hb., 55 per cent. 

 Leucocytes, 8200, of which: 

 Polymorphonuclear neutrophiles, 38 per cent. 

 Large mononuclears, 37 per cent. 

 Lymphocytes, 54 per cent. 

 Eosinophiles, 4.3 per cent. 

 Nov. 26. 0.0005 gin. adrenalin sub- 

 cutaneously and 50 gm. dextrose per os. 

 After four hours 3.2 per cent, sugar. 



Nov. 29. One drop homatropine in eye; 

 twenty-four hours later, still slight mydriasis. 

 Nov. 30. Adrenalin, 0.0005 gm., no 

 sugar. 



Nov. 20. 0.005 g m - pilocarpine sub- 

 cutaneously, weak sweat, no salivation. 



From Dec. 2 on, two thyroidin tablets 

 daily; from 6th on, three daily; from 8th on, 

 five daily. 



Dec. 14. Pulse that was formerly no, 

 now 130; thyroidin medication now reduced 

 to one tablet. 



Summary. We are dealing with a case of 

 sporadic cretinism, probably depending on a 

 congenital aplasia or hypoplasia of the 

 thyroid. 



Here are worthy of note the high assim- 

 ilation boundary for sugar, the failure of 



adrenalin glycosuria, the strong action of atropine and the weak action of pilocarpine; 

 there is, -however, found an unusually high glycosuria on combination of dextrose and 

 adrenalin. There occurs in this case a somewhat high tolerance for thyroidin. 



Rontgen investigamm of the skeleton of the hand, Nov., 1911: The bone-nuclei 

 of the os magnum and the unciform bone are present. Those for the epiphysis of the 

 radius and the basal epiphysis are still absent. The skeleton corresponds to that of a 

 six- to eight-month-old child (Fig. 12). 



Sella turcica corresponding to the size of the skull. 



Observation XV. Franz N. (see Fig. 13). Entered the psychiatric clinic of Wagner 

 Oct. 6, 1909, four and one-half years old, from Rudoletz in Mahren. 



The fourth child of healthy parents. Birth easy, at the right time. Head at birth 

 already large. Speech up to the second year of life consisted of the simplest words 

 only; words were such as tata, mamma, and since this time the child has not spoken 

 much otherwise. 



Parents and the entire family to the great-grandparents of the child have not suffered 

 from goiter. Nowhere in the neighborhood does the father know of a similar case. 



Length of body 85 cm., weight 19.2 kg. Head extremely large without, however, any 

 hydrocephalic formation. Bones of the head of hard consistency. Strong development 



FIG. 13. Sporadic cretinism. 



