i6o 



THE CRETINIC DEGENERATION 



slowed, the memory very poor; as for the emotions, the cretins show a certain 

 clinging for the persons who feed them or hate against those whom they 

 regard as enemies. 



The pathologico-anatomical findings in the brains of cretins are very di- 

 verse. Often they are only trivial; in most cases, however, there are found 

 several alterations, and these of greater intensity. Scholz and Zingerle 

 found at times chronic meningitic alterations and a slight grade of hydro- 



FIG. 19. Endemic cretinism. FIG. 20. Cretins with myxedematous facial expression. 



cephalus. The brain may be smaller in to to or in individual lobes; often it 

 is highly asymmetric, sometimes there is found a persistence of the juvenile 

 developmental stages, or in rare cases excessive development. The dis- 

 turbances of development may affect the hemispheres as well as the brain- 

 stem, the cerebellum, etc. The confirmation of the surface of the brain 

 is often pathologically affected in that the convolutions are smaller or their 

 number lessened. In abnormally small brains of cretins it may well be sup- 

 posed that the smallness of the brain is primary, that of the skull secondary; 



