. The thyroid gland in health and disease. on of the lateSir Victor Horsley, ) of all intellectual and sense functions. Mental torpor is marked ;all cretins are idiotic or imbecile in greater or lesser degree ; theyare commonly deaf-mute or mute, or their powers of hearing andspeech are defective ; they sleep heavily and are not easifyroused. Cutaneous sensibility is impaired and burns and woundsheal badly. The excreta may be passed under them. Themuscular system is ill-developed and lacks tone ; the head fallsforward on the body ; the abdomen protrudes, due partly to 136 ENDEMIC CRETINI
. The thyroid gland in health and disease. on of the lateSir Victor Horsley, ) of all intellectual and sense functions. Mental torpor is marked ;all cretins are idiotic or imbecile in greater or lesser degree ; theyare commonly deaf-mute or mute, or their powers of hearing andspeech are defective ; they sleep heavily and are not easifyroused. Cutaneous sensibility is impaired and burns and woundsheal badly. The excreta may be passed under them. Themuscular system is ill-developed and lacks tone ; the head fallsforward on the body ; the abdomen protrudes, due partly to 136 ENDEMIC CRETINISM muscular relaxation, partly to the disproportionate size of theabdominal organs to the skeleton. Hernias of the umbilicusand other orifices are common. The umbilicus is usually everted(fig. 60). The child supports himself with difficulty—and if itmoves at all it crawls about in a sluggish way on its handsand knees, or if it does learn to walk eventually it does sovery late. The depression of the metabolic processes and the impairment. Fig. 60.—Cretin showing marked spinal curvature. Compare with fig. early effects of treatment are shown in the right-hand figure. (Reproduced by-courtesy of Dr. John Thomson.) of nutrition and elimination lead to the deposit of mucin andfat in all organs and tissues of the body. This deposit occurschiefly in the subcutaneous tissue. The body swells, supra-clavicular pads of fat appear, the limbs may become thick andstumpy (fig. 59). Sometimes the swelling is chiefly abdominal,and then the limbs may be thin and the skin loose (fig. 60).The nutrition of the skin and its appendages is poor : the skinis harsh and scaly ; the hair coarse and ill-grown ; the nailsimperfectly formed and cracked ; the sebaceous and sweat glands MINOR CONGENITAL HYPOTHYROIDISM 137 are inactive. The temperature is subnormal. Infiltration ofthe muscles, ligaments and cartilages increases the muscularweakness and renders movement sluggish; the involuntaryand vol
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishernewyorkwilliamwood
