Cretinism.

This form of myxedema follows either a congenital absence of the gland or loss of its function during the first few years of life. The chief symptoms are those that arise from lack of development, the child retaining an infantile appearance, both in its physical and mental make-up.

The first physical or abnormal conditions may not appear for six or eight months after birth, at which time it is noticed that the child's development seems to be arrested. The awful dread arises in the mother's mind that the baby is not "bright,", which becomes verified as the months pass. The physical development is also remarkably retarded. The anterior fontanels remain open, and the head becomes enlarged, narrow in front, but large posteriorly. The face becomes large and bloated, the nose broad, flat, and slightly turned up at the end, the eyes appear to be widely separated, the cars are large, the tongue is broad and thick, and often protrudes from a large mouth. The complexion is waxy or of a dull, chalky color. The hair is coarse, and usually thin. Dentition is delayed, and the teeth early decay.

The neck is short and the clavicular fossae are filled with fatty tumors. The body is short and stunted, the skin dry and harsh, the arms and legs are short, and the hands and feet puffy and enlarged. The abdomen is bloated and prominent, and the child is unable to stand alone. The whole appearance of the child is repulsive. The condition may not arise until three or four years after birth, and follow some one of the infectious fevers, which in some way impairs the function of the thyroid gland. There is arrest of mental development in either case, and the child becomes an imbecile.

Prognosis.—Congenital cases usually live but a few weeks or months, while those developing early in childhood may live for years.

Treatment.—The treatment is along the same lines as for myxedema in the adult.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.