INFANTILISM 871 



and under certain conditions also as a consequence of long continued 

 infections, especially of lues; in descendants of parents who are suffer- 

 ing from chronic alcoholism, morphinism, saturnism, pellagra, tuber- 

 culosis, malaria, leprosy and other endemic diseases ; in individuals who 

 live in poor, unhygienic surroundings and suffer from various depriva- 

 tions, especially from insufficient alimentation. In other cases, in 

 which no definite cause is discoverable, the presumption of a primary 

 defectiveness of the germ plasm or an original deviation from the 

 normal of the Keimanlage, possibly based upon inheritance must be 

 resorted to. Joffroy describes infantilism associated with "paralysie gen- 

 erale juvenile," and Falta observed it in combination with progressive 

 muscular atrophy. But it must be insisted that none of these causes alone 

 will give rise to dystrophic infantilism; probably circumstances not well 

 known in the concrete cases with inborn tendencies must cooperate. 



The question as to the role played by the ductless glands in dystrophic 

 ("true") infantilism remains still sub judice. The tendency is coming 

 more and more to the fore to assume that even where a chronic disease 

 early in life has been followed by dystrophic infantilism, this faulty de- 

 velopment is really the effect of the altered relation of one or more endo- 

 crin glands or is due to direct changes in the histologic structure and 

 resulting dysfunction of the pituitary body. Hertogh's exclusive view- 

 point that the thyroid holds a central position even in the presence of 

 these causes enumerated (lues, etc.), that only a preexisting disturbance 

 of the thyroid or one provoked by these agencies could bring into existence 

 an infantilistic stunting of growth, is no longer tenable, in the face of 

 accumulating clinical facts. Ferranni and others have pointed out many 

 cogent reasons militating against this extreme contention. In the view of 

 some investigators it is more probable that not one hormone gland is 

 particularly responsible but rather the entire endocrin system participates 

 more or less in the general developmental affection. Falta cannot share 

 the theory that in dystrophic (true) infantilism the endocrin glands hold 

 any important pathogenetic position and argues that during the standstill 

 of the entire organism at the childish stage of development naturally the 

 ductless glands system likewise remains infantile, just as do the skeleton 

 or the nervous system. He considers the hypoevolution of the endocrin 

 chain to be merely coordinate with that of the remainder of the organism. 

 Indeed we see at least no evidences of disturbed correlation among the 

 ductless glands : they functionate harmoniously but only on the scale fully 

 suited to the childish conditions. There is no falling away of the genital 

 function, for signs of eunuchoidism are lacking; but the function is that 

 of childhood, thus explaining the lack of secondary sexual characters. 

 The sexual glands of "true" infantilism or the infantile genitals are 

 essentially different from those of eunuchoidism. Also anomalies of 

 skin, adipose tissue, metabolism, body temperature, etc., peculiar to true 



