. DYSTROPHIC CONDITIONS OF INFANCY 15 in good health. The mother has borne seven children and hashad no miscarriages. Five of the children were normal. Theeldest child, a boy, now 15 years old, was born with a peculiardeformity: the right arm appeared as if it had been amputatedjust below the elbow joint, and on the stump were five small, soft,fleshy knobs looking like rudimentary fingers. E. G. was thesecond child. The third child died of diphtheria at the age of6 months. The remaining four children are all living and ingood health; they are respectively, a girl 9 years, a boy 7


. DYSTROPHIC CONDITIONS OF INFANCY 15 in good health. The mother has borne seven children and hashad no miscarriages. Five of the children were normal. Theeldest child, a boy, now 15 years old, was born with a peculiardeformity: the right arm appeared as if it had been amputatedjust below the elbow joint, and on the stump were five small, soft,fleshy knobs looking like rudimentary fingers. E. G. was thesecond child. The third child died of diphtheria at the age of6 months. The remaining four children are all living and ingood health; they are respectively, a girl 9 years, a boy 7 years,a girl 4 years, and a boy 2 years old. E. G. was born after a normal non-instrumental labor. Herappearance at birth was not that of a normal infant. She wasjaundiced, and her tongue was large and protruded from hermouth. She was breast-fed until 18 months old, and began towalk and to cut her first teeth at 15 Fig. 10. E. G. Same case as in Fig. 9. Note the broad handsand feet, the puffy, wrinkled skin and the slight umbilical hernia. As an infant she was markedly undersized and mentally de-ficient. The anterior fontanelle remained patent until the thirdyear of life. It is remarkable that she contracted none of theinfectious diseases of childhood, although she was exposed withother children in the family who had scarlet fever, measles, and 16 ALEXANDER SPINGARN diphtheria. When six years old she was treated for one monthat the New York Post Graduate Medical School Hospital, withno appreciable improvement. Previous to that time and for thefollowing 7 years she had no treatment. In May of this year,she developed mastoiditis following an acute suppurative otitismedia and was operated upon at the German Hospital of Brook-lyn. While convalescing at this institution, she was placed under Fig. 11. E. G. Same case as in figures 9 and 10. Note the prog-nathism, the pendulous abdomen and the lumbar l


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