. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. dematoustype. The skin, especially that of the face, has a greenish-yellow,, putty appearance. The upper and lower eye-lids are swollen,as in nephritis. With these appearances there are the dry hair, themacroglossia, the guttural voice, the dwarfish appearance, the pro-tuberant abdomen, and the mental dulness. The expression of theface is less prognathous than in the first form. In one of my casesthe infant was in good health until the sixteenth month. It then devel-oped abscesses ove
. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. dematoustype. The skin, especially that of the face, has a greenish-yellow,, putty appearance. The upper and lower eye-lids are swollen,as in nephritis. With these appearances there are the dry hair, themacroglossia, the guttural voice, the dwarfish appearance, the pro-tuberant abdomen, and the mental dulness. The expression of theface is less prognathous than in the first form. In one of my casesthe infant was in good health until the sixteenth month. It then devel-oped abscesses over the body, after which the sjTnptoms of cretinismwere noticed. The abscesses were peculiar, the granulations slug-gish, and the pus was creamy. The skin v\as not edematous, butmyxedematous. In both forms the hands are large, flat, and s])ade-like. The hviK)- DISEASES OF THE THYROID GLAND 707 thenar eminence is thick, square, and hypertrophied, as in the loweranimals (Koplik and Lichtenstein) (Fig. 194). In some cases thethyroid gland cannot be felt, in others it is small, and in exceptional i^*^ ..X. Fig. 192.—Sporadic Child, aged fifteen months. cases there is goiter (7 cases of Osiers series). In some cases supra-clavicular of fat or fatty tumors behind the are apparent. I ha\e ^^een of fat in cases whichhad suffered a return of .symptoms after susjjension of treatment. 708 DISEASES OF LYMPH XODES, DUCTLESS GLANDS AND BLOOD Etiology.—The etiology of sporadic cretinism is as yet absolutelyunknoivn. Experimental and operative pathology have demonstratedthat interference with the function of the thyroid gland (athyreosis)
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