Pediatrics : the hygienic and medical treatment of children . es, and the increaseddensity due to the sclerosis of the shafts of the long bones. Skin and Mucous Membeanes.—The skin shows a thickeningof the subcutaneous tissue, giving a brawny, doughy sensation. Atrue edema with complete loss of elasticity of the skin is never addition to this thickening of the subcutaneous tissue, in certainplaces the entire skin appears to be abnormally loosened upon theunderlying tissues. Disturbance of the nutrition of the epithelial Spoeadic Cretinism 347 elements of the skin gives rise to rough
Pediatrics : the hygienic and medical treatment of children . es, and the increaseddensity due to the sclerosis of the shafts of the long bones. Skin and Mucous Membeanes.—The skin shows a thickeningof the subcutaneous tissue, giving a brawny, doughy sensation. Atrue edema with complete loss of elasticity of the skin is never addition to this thickening of the subcutaneous tissue, in certainplaces the entire skin appears to be abnormally loosened upon theunderlying tissues. Disturbance of the nutrition of the epithelial Spoeadic Cretinism 347 elements of the skin gives rise to roughness ,cracking of the nails,coarseness, brittleness and loss of hair, and diminished secretion ofperspiration leading to a characteristic dryness of the skin. Similar changes are seen in the mucous membrane of the nose,pharynx, middle ear, larynx, eyelids, and digestive tract, the changesleading to various functional disturbances, such as mouth breathing,snoring, grunting, a coarse voice, disturbances of hearing, refusal offood, and constipation. Fig. 24S. Sporadic cretinism in an infant lo months old, terminating in sudden death The changes in the skin and mucous membranes combined withthose of the bones and with lack of mental development, give to thecretin its characteristic appearances. The forehead is low and reced-ing, with sparse hair; the nose is broad and saddle-shaped; the open-ing of the eyes is narrowed by the thickened eyelids; the thickened,protruding lips leave the mouth half open and disclose the thickenedand protruding tongue; there is usually a double chim; the ears arelarge and shapeless; the normal skeletal outlines of the rest of thebody are partly concealed by the thickening of the soft parts; thereare often pads of thickened 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 h
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatr, bookyear1917
