. A treatise on the nervous diseases of children : for physicians and students. d large ; thehair is stiff and dry; the childis dwarfish in stature ; the men-tal condition is that of completeidiocy or of imbecility. Thereis always absence of the thyroidgland. Myxoedema resembling thatof the adult may come on atthe age of puberty, or even ear-lier. It is characterized by thefollowing symptoms: A gen-eral increase in the bulk of thebody; the skin is firm and in-elastic, does not pit upon press-ure, and is dry and rough ; thefolds of the skin disappear, and there is a general obliteration of all
. A treatise on the nervous diseases of children : for physicians and students. d large ; thehair is stiff and dry; the childis dwarfish in stature ; the men-tal condition is that of completeidiocy or of imbecility. Thereis always absence of the thyroidgland. Myxoedema resembling thatof the adult may come on atthe age of puberty, or even ear-lier. It is characterized by thefollowing symptoms: A gen-eral increase in the bulk of thebody; the skin is firm and in-elastic, does not pit upon press-ure, and is dry and rough ; thefolds of the skin disappear, and there is a general obliteration of all the linesof the skin, particularly in the face, giving, as a rule, an older and more stu-pid expression to the face ; the nostrils and lips are very much is distinct apathy and slowness of speech, as well as of action, in someinstances ; the mental changes include delusions which lead to and glycosuria have been observed ; but these are accidentalcomplications, no doubt. The disease cannot be mistaken for any other, except possibly chronic. Fig. 50.—Case of Myxoedema with Idiocy. Pa-tient Twelve Years Old: Dwarfish in Stature. VASOMOTOR AND TROPHO-NEUROSES. 20/ nephritis; but the lack of pitting, the examination of the urine, and the pe-culiar expression of the face will help to remove all doubts. The disease is slowly progressive, and may last for ten, fifteen, or moreyears. The prognosis was hopeless until the recent discovery of thyroidfeeding, and success of this warrants us in rejecting for the present every otherform of treatment. Treatment is to consist of the administration of the pulverized thyroidgland of the sheep, which is to be had in all countries. An English prepara-tion is, up to the present time, by far the most satisfactory. Care should be taken to begin with small doses; in children one graintwice a day should be the maximum dose at the beginning ; this may be in-creased to three or five grains twice daily until the amoun
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