INFANTILISM 



861 



trunk, prominent abdomen, low umbilicus and rudimentary genitals. The 

 latter are a manifestation of secondary dysgenitalism with its further 

 consequences, the underdevelopment of the secondary sexual characters. 

 The subcutaneous tissue is not firm but flabby and doughy, though at first 

 sight resembling that of an infant. The skin is not smooth and moist but 

 scaly, rough and dry, the perspiration being absent or very scanty. 

 Radiograms demonstrate delayed ossification. The pulse rate and metab- 

 olism are retarded. The face is ex- 

 pressionless but less stolid than in 

 athyreosis. 



The intelligence seemingly is al- 

 ways affected though occasionally only 

 to a slight extent. The perceptive and 

 thinking processes are dull, heavy, slow 

 and clumsy, as seen in the inefficiency 

 or mediocre progress in school. How- 

 ever, the patients may learn reading, 

 writing, and arithmetic, and may pass 

 through the elementary schools even 

 with fair results in exceptional cases. 

 Even where there are present less con- 

 spicuous degrees of impairment of the 

 intellect, in the affective sphere the 

 anomaly may be more pronounced, as 

 the monotony of the facial expression 

 demonstrates. The muscular actions 

 are slow, sluggish and clumsy; this is 

 illustrated in their gait. Thus, we no- 

 tice, some of the characteristics enum- 

 erated have rather the stamp of a path- 

 ological nature in opposition to the 

 features of the normal infant and the 



functions of its organs. The various discrepancies, on the whole, convey 

 the impression of premature senility, so conspicuous in the "old age" face 

 of young cretins rather than that of infancy. 



Dysgenital Infantilism. As discussed at length in the chapter on the 

 gonads and their diseases, the sexual glands are not, as are the thyroid, 

 hypophysis or some other ductless glands, indispensable for the existence 

 of the individual; but they exert an important influence upon the or- 

 ganism, especially at the puberty, though to a certain degree also before 

 that period. 



Castration in earliest youth causes, as the principal sequelae, deficiency 

 of the external genitalia and the accessory sex structures, with impotency 

 and absence or underdevelopment of the secondary sexual characteristics, 



Fig. 2. Same case as Fig. 1 ; after 

 3 years' treatment with thyroid. Pro- 

 nounced acceleration of growth; entire 

 somatic and psychic change. Original 

 illustration ibidem. 



