Case of sporadic cretinism treated with thyroid gland / by T. Telford-Smith.

  • Telford-Smith, Telford.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Case of sporadic cretinism treated with thyroid gland / by T. Telford-Smith. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    tures were all sharper and clearer. His Bkin was becoming softer and smoother. He had had a kind of scurfy, dirty patch on his nose and forehead, which soap would not remove; this came off almost in one piece, like a crust. He perspired rather copiously, especially about the head. May 13th. The skin on the feet and hands was peeling. He was much brighter and more active. His tongue was now normal in size and appearance, having lost the thick blunt shape and blue tinge. He could run fairly fast without awkwardness. July 6th. Mentally he was wonderfully bright; he liked to talk and answer questions, and had learnt “ Little Jack Homer” from a girl patient. His vocabulary was enlarging considerably. He was full of spontaneous playfulness and mischief. Physically he had got very thin, except in the face, which was plump and healthy-looking without the least sign of puffiness. His appetite was good, and his bowels regular, without constipation. He was cutting two lower central incisors. On June 5th the dose was diminished to one twelfth, as he was getting thin. He did not take the gland after July 7th, and, on Septem- ber 13th, it was noted that he began to show signs of slowly reverting to his former state. The condition of solid cedema was quite perceptible again. His speech was not so distinct nor so quick, owing to the tongue beginning to thicken and to his mental state not being so active. He was not so bright, and he had lost some of his spontaneity. On Sep- tember 16t.h he was put on one tabloid (Burroughs and .Well- come) once every day at dinner time—equivalent to one- twelfth of a lobe. On October 18tli I took him to Manchester to go home to his parents for a holiday, and showed him that evening at the Manchester Medical Society. (Dr. Railton also showing the eldest brother, whom he was treating with thyroid.) The members of the Society, who had seen the two brothers before, were struck by the very marked .change for the better in them both. December 13th. The patient returned to the Royal Albert Asylum from home, where he had continued taking one tabloid every day. His mother said he had become so active and mischievous that she could hardly put up with him. His father’s report, on bringing him back, was : “I find that my son, D. B., has improved very much ; he is much brighter and more cheerful and inte’ligent than before in every way.” He was now cutting two upper central incisors. February 16th, 1894 He has continued to take one tabloid a day. and maintains his mental and physical improvement. He is growing taller, and is activp in all his functions. There are at present few traces of sporadic cretinism about him. The umbilical hernia is now imperceptible. His average tempera- ture before treatment was 95°; since treatment it has been about 98°. Remarks. Dr. Byrom Bramwell, in his “Clinical Remarks on a Case of Sporadic Cretinism,” in the British Mebical Journal of January 6th, notices that “an umbilical hernia is nearly always present in cases of sporadic cretinism;” this is cer- tainly so in the greater number of the cases, but it is perhaps worth recording that there have been two (out of four) rather