474 VEGETATIVE DISTURBANCES 



remain little children all their lives, to the poorly pronounced formes frustes. 

 Very important for the differentiation of the forms is also the consideration 

 of the phase of development at which the noxus set in. "Every age period 

 has its infantilism" (di Gasperd). When the noxus sets in relatively late 

 .there results a form which has been termed "juvenilism." In this the skele- 

 ton is no longer purely childish. The genitalia are relatively well developed, 

 etc. We find very commonly the juvenile form of psychic infantilism in 

 ordinary life (Anton). According to whether the inhibition of develop- 

 ment has affected the more the skeleton, the psyche, or the genitalia, etc., 

 we may speak of partial infantilism. An instructive example of a juvenil- 

 ism furnished by a case briefly reported by A pert and Rouillard. In a 

 thirty-eight-year-old man who had developed normally up to his sixteenth 

 year, there occurred in the wake of a typhoid fever a remaining behind in 

 corporeal and sexual respects, at this developmental period. There were 

 present no signs of eunuchoidism. A pert and Rouillard attribute this in- 

 hibition in development to the thyroid gland. As no signs of myxedema 

 were present, I would dissent from this view. 



The excessive form of infantilism might well coincide with the hypo- 

 plastic dwarf of Breuss and Kolisko. Breuss and Kolisko indeed state that 

 in the hypoplastic dwarf only the height is childish, the other dimensions 

 only in part childish. Probably in such individuals the disturbance Mas its 

 onset in fetal life or in early youth. 



Etiology. The etiology of infantilism is very manifold. The most 

 divergent toxic and infectious deleterious agents are blamed. Alcoholism, 

 saturnism, nicotine-poisoning agents that may also have affected the 

 parents further malaria, pellagra, syphilis (a fine example is furnished by 

 Perelz), tuberculosis, abdominal typhoid in early youth (see the case of 

 A pert and Rouillard); polyserositis (v. Neusser), deficient development of the 

 cardiovascular apparatus (Hb'dlmoser has communicated "a pronounced 

 pertinent case that was only 125 cm. tall with a lower length of 66 cm.), 

 and further cardiac defects acquired in early youth (Gilbert and Rathery) 

 (and in this nanisme cardiaque the genital disturbance may eventually be- 

 come less pronounced) , and the traumata that may affect the children in early 

 youth (the case J. H., Observation LVI, suffered a commotio cerebri at the 

 age of seven years) . Joffroy described two cases of paralysis generale juvenile 

 with pronounced infantilism. I have reported such a case above (see 

 Observation LVII, W), further it has been supposed that unfavorable condi- 

 tions of life, and conditions of nourishment in early life are causal factors, 

 and also disturbances of nutrition, chronic diarrheas, etc., existing since 

 early life (see later concerning pancreatic infantilism). The position of 

 the cases with hydrocephalus does not seem to me assured as yet, in these 

 cases consideration must be given especially to signs of hypophysial in- 

 sufficiency, especially the distribution of fat. 



