Identifier: 39002086410504.med.yale.edu
Title: The practice of pediatrics
Year: 1906 (1900s)
Authors: Carr, Walter Lester,1859-
Subjects: Children
Publisher: Philadelphia : Lea
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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ght. The face is very striking and well illustrated inPlate XXVI. The expression is pig-like. The base of the nose isbroad and the eyes wide apart. The eyes are slit-like, reminding one ofpigs eyes; the eyelids are puffy. The eyebrows are scanty or wanting.The cheeks are large and sag. The lips are prominent; the tongue isthick and usually protrudes through the half-open mouth. There is aptto be drooling. The teeth are erupted late and are apt to decay early.The neck is short and the head seems set directly on the trunk. Thearms and legs are short and misshapen. The patients assume a squattyattitude and generally have more or less kyphosis or lordosis. Thehands are short and spade-like, with broad, prominent hypothenareminences. The genitalia are edeniatous-looking and remain unde-veloped throughout life in the untreated cases. The abdomen is prom-inent and pendulous. The skin is coarse and rough, sallow andwaxy. There is a tendency to eczematous skin eruptions. The entire PLATE XXVI.
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Sporadic Cretinism. Child fifteen months of age. (Koplik.) CRETINISM 853 body has an edematous appearance, but there is no pitting on pressure.The thyroid may be absent and there may even be a depression in itsplace. In the older cases there may be subcutaneous fatty tumorswhich are usually symmetrical and most frequently just above theclavicles or above the shoulders. Many cretins are deaf-mutes, but ifthey talk the voice is hoarse and guttural, There is usually markedconstipation. If the cretin walks at all he is late in learning, and hemay be five or six years old before he makes any effort. When he doeswalk the gait is uncertain and of a waddling character. Cretins aresluggish, lethargic individuals, who lead a rather vegetable type ofexistence. They may have epileptiform seizures. As time progresses all these features become more pronounced.They remain short and undersized, and when the disease has begunin early infancy a cretin of twenty may have the appearance of a childof thre

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