INFANTILISM 



865 



intermediary position by its proportions and shape; its configuration 

 retaining some infantile characters. In addition to that, the total height 

 of the head in comparison to the body is greater than in the adult, thus 

 approaching the infantile proportions also in this respect, and enhancing 

 the impression of immaturity which the general aspect gives. Paradigms 

 of nanism of this group were reported by Paltauf (112 cm.), Hueters 

 (106 cm.), Burnier (125 cm.) (cited by Peritz), Falta, Priesel and others. 



Many varieties deviating from this class- 

 ical type do occur, without completely obliter- 

 ating the original, depending on the age of the 

 patient at the beginning of the affection, the 

 degree to which the anterior and the posterior 

 lobe of the hypophysis or the base of the mid- 

 brain with its center of metabolism is in- 

 volved and according to the degree of secondary 

 dysgenitalism. . Where manifest cachexia 

 would be associated with hypopituitarism (as 

 in the observation No. 45 of Falta) the clinical 

 differential diagnosis from multiple ductless 

 glandular disease would be difficult. 



A brief discussion of those not infrequent 

 cases of monstrous adiposity of pituitary 

 origin may be permitted, which Neurath (a), 

 under the title "Fettkinder," has described and 

 illustrated. A characteristic instance was the 

 following: A boy, aged ten years, developed 

 a monstrous adiposity at seven years of age 

 following scarlatina; the growth was remark- 

 edly retarded, and the boy suffered from at- 

 tacks of headache and vertigo. His height, 



109 cm., corresponded to that of a normal boy of six years, while his 

 weight, 36.8 kgm., was that of a 13-year-old boy. The circumference 

 of the head was 53 cm. The testicles were well developed ; the penis was 

 hidden in the adipose tissue of the mons veneris. The radioscopic examina- 

 tion of the skull revealed signs of hydrocephalus, but a normal sell a 

 turcica. Neurath asserts that an affection of the hypophysial gland in 

 this and similar instances may be caused by a hydrocephalic effusion due 

 either to serous meningitis complicating scarlatina or to a small tumor, 

 escaping the detection by the #-rays. 



In analogous cases, as those reported by Marinesco and Goldstein, 

 Babonniex and Paisseau, Kruckemann, and Kurt Goldstein, the pathoge- 

 netic factor was a pressure lesion with consequent functional deficiency of 

 the hypophysis through hydrocephalic effusion that distended the third 

 ventricle. Among the patients some are of strikingly small size and have 



Fig. 5. Frontal view of Fig- 

 ure 4. 



