. Case histories in pediatrics. : A collection of histories of actual patients selected to illustrate the diagnosis, prognosis and treatment of the most important diseases of infancy and childhood. nlarged, but moist and smooth. She kept itprotruded beyond the lips most of the time. A moderateamount of adenoids was felt with the finger. The throat wasotherwise normal. The neck was of normal length and therewere no supraclavicular pads. The thyroid was of normalsize. She was able to hold up her head, but not to sit was a marked curve of weakness. There was a slightrosary. The heart
. Case histories in pediatrics. : A collection of histories of actual patients selected to illustrate the diagnosis, prognosis and treatment of the most important diseases of infancy and childhood. nlarged, but moist and smooth. She kept itprotruded beyond the lips most of the time. A moderateamount of adenoids was felt with the finger. The throat wasotherwise normal. The neck was of normal length and therewere no supraclavicular pads. The thyroid was of normalsize. She was able to hold up her head, but not to sit was a marked curve of weakness. There was a slightrosary. The heart and lungs were normal. The abdomenwas slightly enlarged, but otherwise normal. The liver andspleen were not palpable. The extremities were of normal DISEASES OF THE NERVOUS SYSTEM. 267 length, the distance from the anterior superior spine to thesole being forty-six per cent of the total length. The epiphysesat the ankles were slightly enlarged. The hands were of goodshape, except that the little fingers curved in rather morethan usual. She had no idea of standing up or what her legswere for. There was no spasm or paralysis. The knee-jerkswere equal and normal. Kernigs sign was absent. There. Helen T. Case 86. was no enlargement of the peripheral lymph nodes. The skinwas normal. The urine was cloudy, straw-colored, acid in reaction, andcontained neither albumin nor sugar. The sediment consistedof amorphous phosphates. Blood. Hemoglobin,Red corpuscles. 70% 5,192,000 12,400 Diagnosis. This child is, of course, an idiot. The historyand the fact that she sees rule out amaurotic idiocy. Thenormal size and shape of the head exclude hydrocephalic and 268 CASE HISTORIES IN PEDIATRICS. microcephalic idiocy. The absence of spasm, paralysis andexaggerated reflexes shows that there is no gross cerebrallesion, either congenital or as the result of hemorrhage atbirth. The enlargement and protrusion of the tongue and theexpression of the face suggest cretinism to a certain ext
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