A case of sporadic cretinism with appearance of myxoedema / by Amand Routh.

  • Routh, Amand (Amand Jules McConnel)
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A case of sporadic cretinism with appearance of myxoedema / by Amand Routh. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    why they do not coincide more exactly is that in this case these changes may not have occurred till 7 years of age, when the sporadic cretinism first became apparent. The face is absolutely expressionless, and the lines obliterated. The features are swollen ; the lips thickened, high-coloured, and shapeless; the mouth usually open ; the nose is flattened and broadened between the eyes, and the nostrils dilated ; the ears large and flat. The head does not hang forward, but the neck appears shortened, being lost in the supra- -clavicular tumefaction. The Skin is everywhere waxy-looking and pallid, with the exception of the face, where there is a slight flush, absent at times, over the flabby, pendulous cheeks, and on the feet and legs, where the circulation is so poor that a state of chronic chillblain exists. The skin is dry and rough in parts, but the palms of the hands are occasionally moist. The hands are spade-like in form. There is no true oedema. The Hair is jet black, and fairly plentiful, but very harsh. The temperature of the body averages 98'8° F. in rectum, but the surface temperature is always sub-nor- ■ mal, being usually between 95° and 96° in the axilla or groin. Once only was it as high as 97°, and that was after the patient had been covered up in bed for some hours. The Thyroid Body cannot be felt. Above the clavicle on either side, and to a less extent immediately below that bone, are well-marked tumefactions, which slip away when grasped, and though somewhat resembling lipo- matous or myxomatous tissue to the fingers, also remind one of the sensation conveyed by grasping a varicocele.