Pediatrics : the hygienic and medical treatment of children . skin above the clavicles and over theshoulder blades, hips, and breast; the limbs are cylindrical or colum-nar in appearance; the hands, fingers, and toes are short and plump;the abdomen is distended and usually shows an umbilical hernia. The Mental Condition.—The mental development not onlyremains very backward, but even shows a tendency toward deteri- 348 Diseases of the Ductless Glands oration. In the severest cases the intellectual level is little betterthan that of animals; in average cases it is always that of a very-much youn
Pediatrics : the hygienic and medical treatment of children . skin above the clavicles and over theshoulder blades, hips, and breast; the limbs are cylindrical or colum-nar in appearance; the hands, fingers, and toes are short and plump;the abdomen is distended and usually shows an umbilical hernia. The Mental Condition.—The mental development not onlyremains very backward, but even shows a tendency toward deteri- 348 Diseases of the Ductless Glands oration. In the severest cases the intellectual level is little betterthan that of animals; in average cases it is always that of a very-much younger child, and untreated cretins may enter late childhoodor adult life with the mental development of a child of two or threeyears. The characteristics of the cretin are those of apathy ratherthan of excitability. They are apt to lie all day without showingmuch reaction to their surroundings, staring apathetically, makingautomatically only the movements of necessity, or sleeping. Whenhungry, or in pain, they bawl loudly. Speech may be impossible, Fig. 246. M3^edema. Female, 5}4 years old or there may be a late acquirement of the ability to say a few less severe cases, the mental impairment shows itself chiefly ininability to fix the attention, to understand, or to talk. They acquirecontrol of the rectum and bladder either very late or not at all. Thefunctions of sitting, standing, and walking are also learned very Development.—There is usually hypoplasia of the testi-cles and of the external genitals. Puberty is delayed, and thereare various disturbances of the sexual function. Sporadic Cretinism 349 Metabolism.—Cretins live upon a low plane of metabolism, thatof protein, water, and salts being particularly diminished. It is inconsequence of this that cretins usually have subnormal temperatures. Muscles.—The musculature is weak and relaxed, although the muscles are not notably diminished in volume. Their condition is closely akin to that seen in pse
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatr, bookyear1917
