Nervous and mental diseases . e, because the cysticdegeneration and interstitial hy-pertrophy at the bottom of thegoitrous enlargement of the thy-roid is destructive in characterand effect. It is easily conceiv-able that myxedema and mentaldisturbances will be developedproportionately to the lack offunctionally active thyroid. Whenthe thyroid is entirely wanting, asin the non-goitrous congenitalcretin, or completely destroyed insome goitrous cretins, the myx-edema is correspondingly intenseand the mental degeneration pro-portionately developed. It wouldseem, therefore, that the causes atthe bo
Nervous and mental diseases . e, because the cysticdegeneration and interstitial hy-pertrophy at the bottom of thegoitrous enlargement of the thy-roid is destructive in characterand effect. It is easily conceiv-able that myxedema and mentaldisturbances will be developedproportionately to the lack offunctionally active thyroid. Whenthe thyroid is entirely wanting, asin the non-goitrous congenitalcretin, or completely destroyed insome goitrous cretins, the myx-edema is correspondingly intenseand the mental degeneration pro-portionately developed. It wouldseem, therefore, that the causes atthe bottom of endemic cretinismare those that produce endemicgoitrous disease, to which the cre-tinoid state is secondary. Theseare not well understood, but usu- allv the soil, drinking-water, and atmospheric conditions are held ac-countable. Infantilism and Myxedematous Retardation.—Occupying amiddle ground between myxedematous idiocy and acquired myxedemathere are numerous cases showing slight cutaneous tumefaction, retarded 33. Fig. -Myxedematous cretin eighteen years old(Parker). 514 NEUROSES. mental development, and diminished growth. These patients retaintheir childishness both in mental attributes and physical here belong some of the idiots classed as Mongolian by theEnglish, and some of the enfants ariearre of the French. In at leastone well-marked instance Brissaud found the thyroid body scarcelyperceptible. At the age of ten numerous and large cervical glandshad been removed with probable resulting damage to the the physical, genital, and mental growth of the lad hadremained stationary. Schmidt l has treated three cases of this sort inwhich growth was retarded, by the administration of thyroids, withimmediate improvement. Etiology.—If we look upon myxedema as the manifestation ofdefective thyroidation, its causes are those of disease or absence of thethyroid body. In some cases it is a teratological defect; in others it isth
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