874 AUGUST STKAUCH 



f 



in some parts of Syria in 1900. Differing morphologically from the 

 slender "graceful" forms of Lorain's type these persons have enormous 

 abdomens due to the intumescence of the spleen and liver. Grotesque 

 figures result from this contrast of general emaciation and enlarged abdo- 

 mens. Orgeas calls attention to the stunting effect of parental malaria 

 upon the offspring of Europeans in French Guiana. He emphasizes the 

 extreme smallness of the body, the flabby skin, the atrophy of the male 

 genitals, and microcephaly as main features of these "variations mor- 

 bides." This degeneracy of the children, especially of the males, from 

 chronic malaria and deterioration of the parents, is one of the chief causes 

 of the extinction of the unmixed white race in the tropical (malarial) 

 lands. 



General Syphilidotoxic Dystrophies. The damage inflicted on the 

 organism by congenital lues not infrequently assumes a character far be- 

 yond the importance of a mere local affection, by involving the organism 

 in universal dystrophy as the remote effect of a local organ lesion, specially 

 of alterations of one or several of the members of the endocrin cycle 

 with subsequent dysfunction. Thus thyreogenic syndromes in early child- 

 hood or in adolescence, hypophysiary dystrophies, nanism, acromegaly 

 even in the young, including formes frustes of it, dystrophia adiposo- 

 genitalis, gigantism and clinical pidtures dependent upon disturbances of 

 the suprarenals and finally pluriglandular symptom complexes have been 

 described. Hutinel in his recent publication on hereditary lues and its 

 dystrophies enlarges on this subject in a masterly manner, illustrating it 

 with numerous personal observations of the various types. 



Pentagna among twenty thousand children found 115 with dysfunction 

 of the endocrin system, namely myxedema, hypofunction of the supra- 

 renal apparatus, pluriglandular disturbances and Mongolian idiocy with 

 congenital lues assured in 46 per cent. In only 23.4 per cent could 

 hereditary lues be excluded and other etiologic factors held responsible, 

 such as chronic alcoholism, hereditary endocrin affections, disturbed preg- 

 nancy, etc. This high percentage seems to indicate the great influence of 

 the luetic infection upon the development of endocrin dysfunction. 



But another group of general dystrophies not infrequently assumes the 

 clinical aspect of Lorain's type of degenerative infantilism. It is not sur- 

 prising that inadequacy or especially lack of specific treatment should 

 have a bearing upon the establishment of the latter. While in the ex- 

 perience of some authors such as Hochsinger, luetic infantilism occurred 

 only in children that had marked heredoluetic manifestations during 

 the first weeks of life. Peritz and others observed it especially in those 

 in whom previous severe local manifestations were absent. These 

 writers point to the striking analogy with tabes dorsalis, which if occur- 

 ring as the juvenile form is often combined with infantile habitus. The 

 general dystrophy may at first, perhaps, be only to a slight extent manifest, 



