878 AUGUST STKAUCH 



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violent general concussion, may be of great pathological importance in 

 causing young individuals to remain in the stage of development which 

 they had attained at the time of the trauma. Stunted growth had followed 

 concussion of the brain in a seven-year-old child, observed by Falta 

 (case No. 56). 



Infantilism Due to Unhygienic Surroundings and Malnutrition. De- 

 pressing circumstances of life, improper feeding, irregularity and lack of 

 sleep, crowded conditions in ill-ventilated and lightless rooms and other 

 obnoxious factors and evil influences summarized under the term "un- 

 hygienic surroundings" often, through their combined effect, give rise to 

 poor physique. This is a matter of common observation . in the slums of 

 many large cities. H. Gilford demonstrated the existence of what is tanta- 

 mount to endemic infantilism in the slum districts of London. The indi- 

 viduals affected are warped both in body and mind, live short lives, readily 

 succumb to disease and break down at an unusually early age with senile 

 decay. Peritz found an enormous percentage of physical and psychic 

 infantilism in the Eumelsburg orphan asylum, occupied by the children of 

 the lowest social strata of Berlin. The inmates are physically and men- 

 tally three yea.rs behind those of the same age who live under favorable 

 conditions. The disparity increases with age so that youths 15 to 16 years 

 old have the appearance of those of ten to twelve years. 



'On a scale unparalleled, because of the involvement of entire nations 

 of previously vigorous physique, the direct stunting effect of qualitative 

 and quantitative chronic underfeeding and starvation is encompassed by 

 the common experience in the recently war-ridden countries of Europe. 

 Yet an astounding recuperative faculty of the growing organism is to be 

 observed, when placed under improved food conditions. 



Progerio as a Manifestation of Infantilism. -Very uncommon disease 

 pictures of an exceedingly pronounced type were described by Hutchinson, 

 Gilford (a) (e), Variot and Pironneau. They have been designated by 

 Gilford "progeria," and by Variot and Pironneau "nanisme type senile." 

 Since the three cases clinically are in every essential very similar, all strik- 

 ing by a senile appearance of high degree and enormous cachexia, as seen 

 also from their photographic illustrations, only the case of Gilford is here 

 briefly abstracted. 



The boy, 15 years old, had a very small childish stature; height 113 

 cm., weight 16 kilos. There existed extreme leanness, so that the bones, 

 tendons and veins were revealed with striking clearness. The general 

 aspect was that of a very pronounced senility ; the skin was very thin, dry, 

 old-looking. Save for a sparse growth of fine gray hair on his scalp, eye- 

 brows and eyelids, he was destitute of hair. There were still many 

 deciduous teeth remaining; the anterior fontanel was not yet closed, the 

 voice was piping (falsetto). The genitals were similar to those of a normal 

 subject a year or two younger. Exitus lethalis occurred at the age of 



