. Diseases of infancy and childhood . uffered with insomnia bynight. Tlie urine was examined and contained no albumin nor sugar. Slight tracesof indican were seen, microscopically nothing pathological. The blood examinationshowed four million six hundred and twenty thousand (4,620,000) red blood-coi-puscles, and seven thousand two hundred (7200) white cells. The percentage of haemoglobin taken with Gowers instrument was about 40per cent. As digestion was very poor I decided to syphon off the gastric contentstwo hours after a meal and to examine the same chemically. CRETrNISM. 725 Feeding.—The
. Diseases of infancy and childhood . uffered with insomnia bynight. Tlie urine was examined and contained no albumin nor sugar. Slight tracesof indican were seen, microscopically nothing pathological. The blood examinationshowed four million six hundred and twenty thousand (4,620,000) red blood-coi-puscles, and seven thousand two hundred (7200) white cells. The percentage of haemoglobin taken with Gowers instrument was about 40per cent. As digestion was very poor I decided to syphon off the gastric contentstwo hours after a meal and to examine the same chemically. CRETrNISM. 725 Feeding.—The feeding was barley water. About 5 cubic centimeters weresyphoned off, which showed traces of peptones, starch, and sugar; HCl was absentby Gunzbergs test. I am. indebted to Mr. Charles LaWall for his assistance in thechemical analyses of the gastric contents, made a number of times. Equal parts of milk and barley water were fed every few hours. Thyroidtreatment was commenced; V2 grain of the desiccated powdered thyroids was ordered. Fig. 210. Crrl iiiisni. Ago 73>^ years. Heightli^y, in lies. Front view. Fig. 211.—Cretinism. Ape 7^4 years. Height2(5)4 iHhes, Back view. three times a day. The dose was gradually increased and the child now receives 3grains three times a day. There was no cardiac disturbance from this dose. Lemon juice, orange juice, raw albumin, and vegetable soups were childs condition improved. The specific effect of the thyroid was very apparent. Case TV.—Gussie S.,^ 7 years and 3 months old when she came under my obser-vation. She was born January, 1807. She is the oldest of four childi-en. The otherchildren are to all appearances healthy, as are also the parents. ^I regard this case as the most complete ty[ie of cretinism that I have everseen. The notes were kindly furnished by Dr. A. K. Isaacs, in whose practice the easeoccurred. •^26 DISEASES OF THE DCTTLESS GLAXDS. Family History.—The mother claims to have had a severe fright duri
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