858 AUGUST STKAUCH 



ous system, the presence of the growth-stimulating products of the well 

 balanced, correlated synergistic and antagonistic activities of the compli- 

 cated endocrin system and on favorable exogenic conditions. General 

 debility and inferiority of the original cell anlage, whereby the cells lack 

 the tendency to multiply and grow normally, deficiency of the growth- 

 stimulating products of inner secretion and untoward external conditions, 

 especially infections, will result in inhibition of development, embraced 

 in infantilism. These evolutionary inhibitions may manifest themselves 

 in manifold morphologic types, complications and degrees, the latter vary- 

 ing from only slight ones to the most pronounced dwarfism (nanism, 

 nanosomia). The chief feature of the clinical pictures, is the inhibition 

 of growth, the infantile size and form. Nevertheless dysgenital gigantism 

 (le gigantisme avec infantilisme) has been given its place here, since 

 aside from other infantile characters, to be summarized later, an important 

 function of the progressive childhood stage, namely longitudinal growth, 

 persists in this condition even up to the thirties. 



The influence the hormon organs exercise upon the development is 

 selective and partial, that is, each individual gland has a more or less 

 specific sphere of influence, and its deficiency will cause a partial 

 developmental disturbance and inhibition of growth. Although the 

 complicated, mutually interlocked functions of the ductless glands may 

 render it very difficult to circumscribe sharply the pathogenetic position 

 of an individual gland within the often complex clinical picture, a patho- 

 genetic differentiation will be possible in a number of cases since the pri- 

 marily affected apparatus reveals itself by setting up predominant specific 

 syndromes of its deranged functions. These manifestations lend a more 

 or less characteristic ensemble to the general clinical picture, as seen in 

 the instances of hypofunction. of the thyroid, the gonads or the hypophysis. 



It was the study of the endocrin system that gave a great impetus to 

 the investigations of the various forms and causes of retarded or arrested 

 development. The importance of the integrity and harmonious solidarity 

 of the hormonopoietic structures is greater indeed in the economy of the 

 growing organism than in mature life, physically and psychically; their 

 disturbances have deeper consequences and are often of somewhat different 

 type. Thus we can appreciate the severity of the detrimental effects upon 

 the young of affections of the thyroid, of aplasia or hypoplasia of the 

 genitals and of certain anomalies of the thymus and pineal glands. 



We owe important contributions on infantilism to Anton, Sante de 

 Sanctis, di Gaspero, Falta, Peritz, Tandler and a number of gynecologists, 

 as Hegar, W. A. Freund, Halban, v. Rosthorn and others who have 

 conducted investigations in connection with the various hypoplasias and 

 the asthenic constitution of the female sex particularly. 



A number of competent observers as Anton, Peritz and some French 

 distinguish two principal types of general infantilism, namely one of 



