466 VEGETATIVE DISTURBANCES 



the type Lorain constitutes a dystrophic condition, and is brought about and 

 maintained by a chronic congenital or inherited disease during the period of 

 growth. 



The views of Brissaud have been adopted in recent time by Bauer. Bauer 

 regards only the type Brissaud as true infantilism and separates all other 

 forms from the type Brissaud as "chetivisme." Hertoghe and Ausset- 

 Breton go still further than Brissaud; they see in all forms of infantilism an 

 expression of a congenital damaging of the function of the thyroid gland and 

 thus seek to establish all forms on a uniform basis. 



Ferranini was the first to oppose this view. Ferranini separates the 

 two forms of infantilism, and regard the type Lorain as the sequel of a 

 developmental deformity, and the type Brissaud as the sequel to the stand- 

 still of development. Ferranini sets forward the significance of the con- 

 genital or early inherited heart defect in the pathogenesis of infantilism 

 (cardiodystrophic infantilism). Carre and Gilbert and Rathery hold similar 

 views. In recent time, especially E. Levi has opposed the views of Brissaud, 

 in that he mentions that not all the true infantilisms are to be referred to an 

 insufficiency of the thyroid gland. The type Lorain should also be regarded 

 as true infantilism. Before this Sante de Sanctis had already again sharply 

 separated the two types and emphasized the significance of various factors for 

 the genesis of the type Lorain, factors such as hypoplasia of the vessels, 

 chlorosis, disposition to tuberculosis, hereditary syphilis, malaria acquired 

 in early youth, pellagra of the parents (Agostini), etc.; furthermore, de 

 Sanctis separated the true form of psychic infantilism from idiocy. Then, 

 too, de Sanctis was the first to attempt to explain the genesis of the type 

 Lorain through alterations in the ductless glandular system. The delay in 

 the physical and psychical development is never the result of isolated 

 alteration of an individual ductless gland, but is produced by a "deviation 

 de la fonction harmonique formative-rjrotectrice de toute les glandes a 

 secretion interne." In an interesting study, R. Anton has described the 

 psychic side of infantilism. General infantilism was defined by Anton as 

 "a developmental disturbance, that causes the entire organism to remain 

 behind at the child type, but prevents the reproduction of the individual in 

 the sense of this species. Thereby not only the physical earmarks, but often 

 also the psychical characteristics of the child persist." 



With general infantilism Anton includes: 



A. The infantilism with myxedema and cretinism. 



B. Mongolism. 



C. Infantilism through absence or atrophy of the genitalia. 



D. Infantilism with primary lesion of the visceral glands, especially the 

 suprarenals, the thymus gland, and the pancreas. 



E. Infantilismus dystrophicus, with the following etiological variation: 

 Infantilism in vascular aplasia. 



