. A treatise on the nervous diseases of children : for physicians and students. e near affections are well devel-oped, as was evidenced whenhe was separated from his fatherand placed in the hospital, andhe shows considerable aptitudein playing with other children,but not quite as much as ahealthy child of three years ofage would. As for his mentalcondition, it is not equal to thatof a child of three years; be-yond the expression of his sim-ple wants, he exhibits remarka-bly few signs of mentality. The disease is characterizedby a peculiar glossy appearance of the skin, prominent
. A treatise on the nervous diseases of children : for physicians and students. e near affections are well devel-oped, as was evidenced whenhe was separated from his fatherand placed in the hospital, andhe shows considerable aptitudein playing with other children,but not quite as much as ahealthy child of three years ofage would. As for his mentalcondition, it is not equal to thatof a child of three years; be-yond the expression of his sim-ple wants, he exhibits remarka-bly few signs of mentality. The disease is characterizedby a peculiar glossy appearance of the skin, prominent lips, receding fore-head, and a peculiar, stubbed nose. Compared with the rest of the body thestomach is inordinately large; the tongue is relatively thick, and very oftenprotrudes from the mouth. All children with myxoedematous disease soclosely resemble each other that they might be supposed to belong to one andthe same family. The examination of the throat fails to reveal any trace ofthe thyroid gland. Etiology.—The etiology of myxoedematous idiocy, as well as of spora-. FiG. 162.—Case of Myxoedema with Idiocy. Pa-tient Twelve Years Old ; Dwarfish in Stature. 646 THE NERVOUS DISEASES OF CHILDREN. die cretinism, is praetieally unknown, exeept that it is very apt to occur inmountainous regions, and particularly in regions in which the water containsa great deal of salts of lime and magnesia. But this is evidently not theonly explanation, for the children of persons who have emigrated from suchdistricts have often been affected with the disease although subject to en-tirely different atmospheric and tellurian conditions. The frequent intermar-riages between people in isolated mountainous districts also has its bearingupon the hereditary transmission of these diseases.* Diagnosis.—Myxoedematous idiocy cannot very well be mistaken forany other condition. It is only in the earlier years of life, when the stuntedgrowth and the peculiar expression of the child are not yet full
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