Diseases of the nervous system : a text-book of neurology and psychiatry . , especially in thehands, fail to develop. The fonta-nelles remain open perhaps to thetwelfth or fifteenth year, and theteeth are slow in body is apt to be fat andthe abdomen especially swollen,in part from gas and obstinatefecal accumulations. Umbilicalhernia is frequent. Other defectsare often present in heart, palate,and other structures, and they die young with the general mentalsymptoms in part described. Diagnosis.—Nephritic edema and other skin edemas must at firstbe ruled out, especially ovarian p
Diseases of the nervous system : a text-book of neurology and psychiatry . , especially in thehands, fail to develop. The fonta-nelles remain open perhaps to thetwelfth or fifteenth year, and theteeth are slow in body is apt to be fat andthe abdomen especially swollen,in part from gas and obstinatefecal accumulations. Umbilicalhernia is frequent. Other defectsare often present in heart, palate,and other structures, and they die young with the general mentalsymptoms in part described. Diagnosis.—Nephritic edema and other skin edemas must at firstbe ruled out, especially ovarian pseudoedema of the menopause andrare forms of syphilitic or familial neurotrophic edema. Chondro-strophia must be separated from the cretinoid complications. Therelations to cretinism are close. There are differences in the skinand perspiration. Deaf-mutism is rare in myxedema, frequent incretinism. This whole problem is too complex to discuss in a text-book.(See Eppinger in Lewandowsky, and Falta, Erkrankungen der Blut-driisen.) Prognosis and Therapy.—See Fig. 46.—Myxedema showing failureof ossification in epiphyses of the bonesof the hand. (Siegert.) CRETINISM 137 Cretinism.—This is a broad, general term applied to a combinationof physical and mental changes which, in the young, result from lossor diminution of the thyroid functions. Such a loss may occur sporad-ically, sporadic cretinism, from causes to be enumerated, where thepicture is analogous to that seen in the adult from removal of thethyroid, cachexia thyreopriva adultorum, or it may occur as a localizedor endemic degeneration, affecting the thyroids of a large number ofindividuals, causing a hypothyreosis which may show a number oftendencies. The chief of these are goitre, goitrous heart, and These three fairly well-separated conditions may be discussed toadvantage under the head of cretinism. In the first place to callcretinism a type of idiocy is misleading. There are numerous
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