INFANTILISM 



471 



At the end of a six weeks' thyroidin medication X-ray examination was again made, 

 without showing any change worthy of mention. 



In this case we are dealing with a typical progressive muscular atrophy, 

 setting in early and associated with an inhibition of development. This is 

 both physical (abnormal smallness, cryptorchidism, etc.) and mental. The 

 large tongue gives rise to a thought of myxedema, but on careful searching 

 no other signs of myxedema were found. Six 

 weeks of the thyroidin medication causes no 

 acceleration of ossification. 



Observation LVIII. R. R., twenty years old. 

 Entered May, 1912. Several cases of tuberculosis 

 in the family. The girl learned to walk only three 

 years ago. Since childhood conjunctivitis eczema- 

 tosa. From youth she has remained behind in 

 growth and in mental development; at present she 

 has the psyche of an eight- to ten-year-old child. 

 Although, on account of her eyes, she never went 

 to school, she can read and write and takes an in- 

 terest in household affairs. 



127 cm. tall. Span width, 128 cm. Lower length 

 (ant. superior spine to ext. malleolus) 63^ cm. 



Very sparse growth of hair in axillae and on the 

 genitalia. 



Adenoids in nasopharyngeal space. Glands of 

 the neck, the elbow, and the groins somewhat en- 

 larged. Slight horizontal furrowing of the teeth. 

 Since sabre-sheath form of the bones, but otherwise 

 no signs of severe rachitis. 



* The mammae on both sides developed distinctly, 

 little glandular substance palpable. First menstrua- 

 tion two days ago, weak. 



Leucocytes, 7700, of which: 



Neutrophiles, 61 per cent. 



Lymphocytes, 32 per cent. 



Large mononuclear, 5 per cent. 



Eosinophiles, 2 per cent. 



X-ray examination. Sella turcica normal, no 

 peribronchial lymph glands. 



Coarse nystagmus on. both sides, the eye grounds 

 show medullated nerve fibers, otherwise they are 

 normal. 



X-ray examination of the skeleton of the hand. 

 The ossification corresponds to about that of a fif- 

 teen- to sixteen-year-old individual. 



Observation LIX. B. B., fourteen years old. Entered May, 1912. It was stated that 

 in the first year the head and abdomen were very large, later good development, could 

 walk at two years, speak at three. Remaining behind in corporeal development, es- 

 pecially since the first year of life. Mental development fairly good. Psyche childish. 



FIG. 83. Infantilism in progressive 

 muscular atrophy. 



