HYPOTHYEOIDISM 



435 



in on either side. This growth has continued until the eyebrows are at 

 present normally extended. The boy became mentally alert. A very 

 noticeable result of treatment was the very rapid development of his second 

 dentition which had been previously quite retarded. A normal growth 

 curve became reestablished. The case is extraordinary on account of a 

 low metabolic rate accompanied by very slight clinical symptoms aside 

 from decrease in size of the thyroid. From this observation it would seem 

 probable that many cases of hypothyroidism go undiscovered. 



Fig. 18. Thin cranium and underdevelopment of facial bones in a cretinous boy of 

 5 years. Case No. 1939, see text. (N. W. Janney and H. E. Henderson. Archives of 

 Internal Medicine, by permission.) 



Familial HypotUyroidi&m. The following three cases were children 

 of one family. The family history was negative for thyroid disease 

 except as noted. In seeking for the confirmation of the possibility of 

 hypothyroidism in the children, the parents were examined and the father 

 found to be a definite case of dysthyroldism, exhibiting small stature, 

 defective hirsutes, frail nails, stubby extremities, exophthalmos, definite 

 tremor, highly nervous disposition, but no goiter and a normal basal 

 metabolism. The children came under observation merely on account of 

 their failure to grow normally. 



Case No. 19 JO, female, age 2 years; very poor sleeper, and an ex- 

 tremely nervous child. Birth and early growth were normal. By Sep- 



