872 AUGUST STRAUCH 



endocrine-glandular diseases are not features of dystrophic infantilism. 

 The latter, therefore, is to be considered rather a harmonious develop- 

 mental inhibition, a vegetative disturbance of a general nature of the 

 organism in its totality. There may exist combinations of dystrophic 

 infantilism with hypophysial or eunuchoid forms of dystrophia adipose- 

 genitalis, transitional types that pass over into the true primary ductless 

 glandular diseases; combinations with true hypothyroidism, pronounced 

 status lymphaticus, or with other vegetative disturbances, as mon- 

 golism, etc. Falta's case (No. 61), a heredoluetic boy, affected with 

 dystrophic infantilism and manifesting a more or less noticeable eunuchoid 

 distribution of fat tissue, represents such a mixed form. 



Dystrophic Infantilism in Status Thymicolymphaticus. The status 

 thymicolymphaticus with its clinical and anatomical varieties is the 

 subject of another chapter in this handbook ; therefore only a few remarks 

 will be made here. This constitutional anomaly is not associated with 

 formal infantilism in every instance. Bartels measured thirty individuals 

 and found that ten had exceeded while only five were beneath the average 

 size, the reduction of the body length being not more than 4.9 per cent. 

 In other instances the growth may be much stunted. It is probable that 

 lymphatic hyperplasia and the associated developmental anomalies of 

 other organs, such as the vascular hypoplasia, genital deficiency, faulty 

 evolution of the chromaph.il system, etc., are coordinated manifestations 

 of a general congenital hypoplastic constitution that manifests itself in 

 all parts, organs and their functions ; that it represents in the true sense a 

 trophic disturbance, from the beginning of the development of the indi- 

 vidual (Bartels). Its farther sequelae are sometimes infantilism or at 

 times chlorotic or angioneurotic symptoms. To what extent the responsi- 

 bility may be due to a disturbance of the internal secretion of the lym- 

 phatic apparatus and its correlation with the central nervous system, and 

 with other endocrin glands, especially the genitals, is not definitely estab- 

 lished, and some authors accord to this variety of infantilism an inter- 

 mediary position between the dystrophic and endocrino-pathologic forms. 



Infantilism Due to Heart Lesions. Infantilism may be the conse- 

 quence of heart lesions (nanisme cardiaque), either congenital or 

 early acquired and chronic, especially of mitral stenosis (nanisme 

 mitral) or pulmonary stenosis. It is not due to any bacterial toxins 

 but probably to faulty circulation with impaired oxygen supply to 

 all organs and the consequent retardation and impairment of all 

 nutritional processes, especially detrimental to the growing organism. 

 However, one should not overlook that congenital vitium cordis 

 frequently is complicated with other developmental anomalies or mal- 

 formations that may contribute to create infantilism, as instanced by 

 the observation of Recklinghausen. The patient, a woman 25 years old, 

 affected with infantile habitus, in addition to a small heart with widely 



