Pediatrics : the hygienic and medical treatment of children . um and bladder either very late or not at all. Thefunctions of sitting, standing, and walking are also learned very Development.—There is usually hypoplasia of the testi-cles and of the external genitals. Puberty is delayed, and thereare various disturbances of the sexual function. Sporadic Cretinism 349 Metabolism.—Cretins live upon a low plane of metabolism, thatof protein, water, and salts being particularly diminished. It is inconsequence of this that cretins usually have subnormal temperatures. Muscles.—The musculat
Pediatrics : the hygienic and medical treatment of children . um and bladder either very late or not at all. Thefunctions of sitting, standing, and walking are also learned very Development.—There is usually hypoplasia of the testi-cles and of the external genitals. Puberty is delayed, and thereare various disturbances of the sexual function. Sporadic Cretinism 349 Metabolism.—Cretins live upon a low plane of metabolism, thatof protein, water, and salts being particularly diminished. It is inconsequence of this that cretins usually have subnormal temperatures. Muscles.—The musculature is weak and relaxed, although the muscles are not notably diminished in volume. Their condition is closely akin to that seen in pseudomuscular hypertrophy. It is probable that not only the peculiar waddling gait of the cretin is due to muscular weakness but, to some extent also the delay in standing and walking, the tendency toward lordosis, the prominence of the abdomen, and the severe constipation which is so often seen in this disease. Fig. 247. Myxedema. Female, 9 years old. Slight improvement after eighty daystreatment with thyroid extract. DIAGNOSIS.—The diagnosis of sporadic cretinism, when thecondition is fully developed, is rarely difficult. The appearance ofa cretin is so characteristic that the nature of the condition canusually be recognized at once. There is sometimes more difficultyin recognizing the disease in its earlier stages before the characteristicappearance has become pronounced. The physician must be pre-pared to exclude other conditions in infancy characterized by deficientmental development. He must further be prepared to exclude cer-tain conditions other than cretinism, in which the growth of the 350 Diseases of the Ductless Glands bones is affected. The principal conditions to be considered indifferential diagnosis are simple backward development, idiocy fromorganic brain disease, Mongolian idiocy, chondrodystrophy, andrickets. Simple Back
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatr, bookyear1917
