848 PETER BASSOE 



mal. The genitalia were infantile. The case is looked upon as prin- 

 cipally of thyroid origin but on account of the proportionate growth it 

 belongs to true dwarfism and not to the disproportionate or false dwarfism 

 associated with ordinary cretinism. The conclusion of the author is that 

 in addition to hypophyseal dwarfism there are rare cases of true dwarfism 

 due to general infantilism and to thyroid deficiency. 



Margarete Levy relates the case of a woman, 44 years old, whose par- 

 ents were normal but a cousin was a dwarf. The patient was of normal 

 size until the age of 4 years. After that she scarcely grew and she only 

 reached a height of 103 cm. (40y L > inches). Her weight was 51 pounds. 

 She had never menstruated. There was no axillary or pubic hair and 

 the breasts were undeveloped. The skin was cold and dry and she never 

 perspired. The thyroid was not palpable. The mental development was 

 normal. Rontgenologic examination of the extremities showed open ep- 

 iphyseal lines. The sella turcica was not enlarged and the skull was nor- 

 mal otherwise. Alimentary glycosuria was produced by the ingestion of 

 100 grams of glucose. 



Two cases, undoubtedly of endocrin origin, though not proportion- 

 ate, are worthy of mention. One, that of a man, 22 years old, 142 cm. 

 (56 inches) tall, weight 27 kilograms, with disproportionately long ex- 

 tremities, is reported by J. Bauer. The testicles were not palpable, the 

 penis was small, trunk devoid of hair, the voice high-pitched. The thy- 

 mus was enlarged, the sella turcica abnormally small. The long limbs 

 were attributed to the eunuchoid condition. Van der Scheer described 

 a female imbecile dwarf of 32 years, with certain acromegalic features, 

 namely a large tongue, prominent lower jaw and accentuated secondary 

 sexual characteristics, while the internal genitalia were poorly developed 

 and the menstruation, which was scanty and irregular, first appeared at 

 26 years. The extremities which were of normal proportion at birth later 

 became abnormally small but chondrodystrophia could be excluded, partly 

 on account of' the normal condition at birth. The Wassermann test 

 was positive and there were scars about the anus so congenital syphilis 

 undoubtedly played a part. The sella turcica was of normal size, and 

 the epiphyseal lines were closed. 



Other Endocrin Disorders Leading to General Dwarfism. In other 

 parts of this work it is pointed out that dwarfism occurs as a feature of 

 infantilism and cretinism, and that the thyroid, thymus and other ductless 

 glands play a part. To avoid repetition these conditions will not be taken 

 up in this chapter. 



False or Disproportionate Dwarfs. A great many conditions in in- 

 fancy and childhood lead to stunting of growth of more or less dispropor- 

 tionate character. Rickets, Pott's disease, and congenital syphilis are 

 the more common causes. These types of dwarfism do not come within 

 the scope of the present work. 



