MONGOLISM 



495 



great similarity to that of the Mongolian races. While in infantile myx- 

 edema the skull is mostly large and pronouncedly brachycephalic, in Mongol- 

 ism it is small and round, the palpebral fissures are small and lack myxedema- 

 tous swelling, they are placed oblique, are slit-like and show epicanthus; 

 the nose is small and sits like a button on the broadened and somewhat 

 sunken nose-root (Kq&owitz) , while in infantile myxedema the root of the nose 

 is strongly retracted, so that the nasal cavities become apparent. Mongo- 

 loids often show a conjunctivitis. The zygomatic arches protrude somewhat, 



FIG. 94. Same case after thyroid treatment. 



the forehead is low and flat, the mouth is small but becomes broad- 

 ened when the patient laughs, the tongue is not enlarged, or not essentially 

 so, is fissured, is always somewhat between the separated rows of teeth, the 

 lower jaw as a ruk projects beyond the upper jaw. The palatal arches are 

 high, the cephalic hairs are soft and silk-like, while in myxedema they are 

 rough and dry and are here and there absent. The ears are small and 

 stand back, the lobules have developed in the form of a triangle (oreille 

 mongolienne) , the facial expression is morose and unintelligent, in Mongol- 

 ism it is vacant and expressionless only in the first years of life. Later it 



