A CASE OF SPORADIC MYXCEDEMATOUS CRETINISM. 
Clinical Lecture, "June 28th, 1894. 
BY 
WM. M. M.D. 
The patient I now presentTO you is 25 years of age. He was 
born in Germany and has been in the United States ten years. 
He is the third child of healthy parents, and was born normally 
at full term. He has always been childish in manner, and is of 
feeble mental development. Although he is 25 years of age, his 
height is but 49 3-8 inches. He is easily amused, and his desires 
and actions are those of a child about six years of age. About 
four years ago he was exhibited in several museums in New York. 
At that time he was between 38 and 39 inches in height. You 
will note that the skull is about normal in size, and measures 21 
inches in circumference. The vertex is flat and slopes anteriorly. 
All the sutures are closed. The hair is black, coarse and dry, 
resembling horse-hair. The complexion is of a dirty yellow 
color. The eyes are apparently sunken in their sockets, and 
widely separated. The upper eyelids are cedematous and over- 
hanging the free border of the lids. The nose is broad and some- 
what flattened at its base. There is well-marked prognathism. 
The tongue presents no abnormity. The teeth and hard palate 
appear normal. 
The thyroid gland is absent. The skin over the body is coarse 
and thick and of a sallow color. The subcutaneous tissue is 
thick and somewhat myxeedematous. The abdomen is prominent 
and pendulous, measuring 27 inches in circumference at the level 
of the third lumbar vertebra. There are a few isolated hairs 
scattered over the pubis. The genitals are largely developed. 
He has a large reducible inguinal hernia. Both legs are bowed 
in a moderate degree, mostly in the tibiae. Epiphyses large. 
Measurement of chest at nipple line, inches. The gait is 
awkward and waddling, and the lower limbs are disproportionately short as compared with the body. The muscular power is feeble. 
Both knee-jerks are active. There is no ankle clonus. No 
objective sensory disturbances. The bowels are always consti- 
pated, and he suffers from frequent hemorrhages due to hemor- 
rhoids. This may account for his anaemic appearance and feeble 
pulse. As this seems to be a suitable case for the experimental 
administration of thyroid extract, I shall advise his admission to 
the hospital with a view to improving his nutrition and for further 
observation and treatment.