INFANTILISM 479 



Probably such cases belong to the so-called hypoplastics of Bartels or to 

 true status lymphaticus. 



Pathogenesis. As I already mentioned at the beginning, the tendency 

 is coming more and more to the fore to regard the cause of infantilism as a 

 disturbance of the ductless glands, or as a disturbance of ductless gland- 

 ular correlations; the disturbances of the correlations is a favorite modern 

 catchword. This opinion I cannot share. I regard true infantilism as the 

 vegetative disturbance dependent on an inhibition of development of the 

 whole organism. But the developmental retardation of the ductless 

 glands is coordinated with that of the entire organism. Hence there is 

 found no disturbance of correlation among the ductless glands, but a func- 

 tion of them graduated for an organism that remains childish, a function 

 fully suited for the childish conditions. In true infantilism, also the sexual 

 glands functionate for signs of eunuchoidism are absent but they function- 

 ate like those of children. According as the damage has occurred in the 

 fetal, the infantile, or the juvenile organism, do there occur fetalism, in- 

 fantilism, or juvenilism. 



A damaging that in youth acts electively on the ductless glandular system, 

 and injures it severely must, according to my view, lead to a vegetational 

 disturbance that is similar to multiple ductless glandular sclerosis. It 

 would condition cachexia and premature senility, but not infantilism. 



The conception of infantilism agrees with that of Anton, who rules out 

 dystrophic -infantilism from the true ductless glandular diseases. The 

 difference consists only in the fact that I limit the idea of infantilism still 

 more and do not class with it the true ductless glandular diseases of childhood. 



I need hardly mention again that this view holds only for the typical 

 forms of infantilism. There are perhaps as many transitional forms as 

 typical forms that pass over into the ductless glandular diseases. These 

 transitional forms may exist between infantilism and various other diseases 

 hypophysial or eunuchoid dystrophia adiposo-genitalis, or pronounced 

 status lymphaticus, with marked hypoplasia of the chromaffin tissue, or 

 true myxedema or cretinism, or other vegetative disturbances yet to be 

 described (true dwarfism, mongolism, etc.). I believe it is better to be pre- 

 cise in the delimitation of true infantilism as in this way the transitory forms 

 that are so frequent, are made easier to recognize and easier to analyze. 



Prognosis. The later fate of true infantilism has not as yet been thor- 

 oughly studied. It is known, however, that the patients show an especial 

 disposition for various diseases and mostly die prematurely (di Gaspero, 

 W, A . Freund, Hegar, et al.) . Especially does tuberculosis reap a rich harvest 

 among them. Also their mentality seems to suffer under the rough in- 

 fluences of life and its severe conflicts. 



Treatment. The treatment in the true forms as yet is almost hopeless. 

 Thyroid gland medication, hypophysis medication, etc., may yield slight re- 



