436 NELSON W. JANNEY 



tember 8 1918 weight attained 24 Ibs. 2i/ 2 oz. On January 20, 1919, 

 weight was 29 Ibs. 2i/ 2 oz., but had only gained 1 Ib. 3% oz. by September 

 of this year. Physical examination is entirely negative but there was a 

 general state of malnutrition which could not be accounted for by intestinal 

 or other obvious causation. Special laboratory tests could not be carried 

 out on account of the tender age. The child, in view of the affected family, 

 was regarded as possibly hypothyroid, although a definite diagnosis could 

 not be made. On minute doses of thyroid, general improvement was noted, 

 the weight increasing one pound in 25 days' time, during October, 1919. 



1 I i 





ft 



Fig. 10. Case 1039. Hands of cretinous boy of 5 years. Case No. 1939, see text. 

 (N. \Y. Janney and II. E. Henderson, Archives of Internal Medicine, by permission.) 



Caw No. 19-19, male, age 5 years, weight at birth normal; walked at 

 second year, but not very well ; began talking at 22nd month. Patient has 

 always boon subject to infections with slight provocation, having had bron- 

 chitis with colitis and slight attacks of asthma. Tonsils and adenoids had 

 boon removed on account of hypertrophy, but the former had partly grown 

 in again. The patient occasionally exhibits patches of dry eczema. The 

 mental development is much under that of his age. He is unreasonable, 

 very nervous, flying into a rage for bnt little reason; showing, even for a 

 child of his ago, very defective memory. During the past two years, but 

 three pounds of weight have been gained. He tires easily and appetite is 



