478 VEGETATIVE DISTURBANCES 



dead. Moher had had lues before the child's birth. Wassermann reaction is still posi- 

 tive. The boy, too, gives a positive Wassermann. The boy learned to speak and walk as 

 late as three years old. At the age of eight, a fall from a second story. Unconsciousness 

 for ten minutes, and, according to statements, no after effects. 



The boy is small, length of body 142.5 cm. Lower length 82% cm. Psyche 

 childish, corresponding to that of a boy thirteen years old. 



Slight sinking-in of the bridge of the nose: Hiitchinson's teeth. No hair at all in the 

 axilla and on the pubis. On the breasts slight collections of fat, collection of fat on the 

 mons Veneris. Penis very small, testicle small, in the scrotum on both sides. 



Scoliosis of the thoracic spine to the left; left pupil twice the size of the right; both fail 

 to react to light, patellar and Achilles reflexes very lively. Hyperesthesia of the whole left 

 side of the body, sharply cut off at the median line. No other nervous condition found. 

 Fundus normal; to X-ray examination sella turcica normal. 



The epiphysial joints of the hand-skeleton are wide open, and the sesamoid bones as yet 

 show no bone-nuclei. 



Diagnosis. Infantilism + dystrophia of adiposo-genitalis of a slight grade, in heredi- 

 tary lues. 



In this case of hereditary lues the excess of the lower length over the upper 

 length militates against pure infantilism. Further, the eunuchoid distri- 

 bution of fat is plainly indicated. The developmental disturbance of 

 the sexual glands is somewhat more pronounced, and is perhaps of hypophysial 

 origin (congenital lues, different symptoms on the part of the nervous 

 system); on the other hand these symptoms are slight in comparison' with 

 the inhibition of growth, and the psyche is decisively childish. 



Just a few words concerning the so-called pancreatic infantilism. Bram- 

 well and later Rentoul have described such cases. In the case of Rentoul 

 we are dealing with a girl eighteen years old, who from youth, suffered with 

 diarrheas (fat stools?). She grew slowly up to the eleventh year, and then, 

 with regard to growth, remained at a standstill to the age of eighteen. She 

 looked like an eight-year-old girl. The stools improved very much on the 

 administration of pancreatin; she now increased rapidly in weight and grew in 

 four months about 2 in. I do not regard as appropriate the term "pancre- 

 atic infantilism." Thereby we might be induced to attribute infantilism to a 

 disturbance of the internal secretion of the pancreas, although in these 

 cases we may be dealing with true infantilism brought about through 

 nutritional disturbances. When the nutritional disturbance improves, the 

 retardation of the development may in part be mitigated. Disturbance 

 of the internal secretion of the pancreas does not lead as far as is known 

 to infantilism. Youthful diabetics do not show infantile features. In several 

 cases of juvenile diabetes I have convinced myself that ossification does 

 not remain behind. 



The vegetational disturbances in early childhood through damaging of 

 the suprarenal cortex are as yet too little investigated that we can delimit 

 them from infantilism. I refer to the chapter on this subject. Apparently 

 hypoplasia of the chromaffin tissue likewise does not lead to true infantilism. 



