Endemic Cretinism (eBook)

Introduction ChaptersI. Etymology of the word ‘cretin’  (Wegelin) II. Definition  (de Quervain)III. Historical (Wegelin) IV. Epidemiology (Wegelin) 1.  Statistics  2.  Geographical distribution  Europe   Asia   Australia   Africa   America  3.  Racial affinity 4.  Relation to endemic goitreV. Course and clinical pattern of cretinism (de Quervain)   Cretinism with and without goitre   Grade of cretinism  Development of cretins  Deterioration  Spontaneous recovery  Influence of endemic goitre on children 1.  The sexual distribution of cretinism 2.  The behaviour of physical development   Growth in non-goitrous cretins  Growth in goitrous cretins   Development quotient  a)  The individual  parts of the skeleton    Behaviour of the skull   Cranial capacity    Dentition   Remainder of skeleton    Appearance of centres of ossification   Joints    Cretin hips   Humerus varus    Pelvis   b)  The skin and its appendages   Myxœdema    Skin shade    Dryness of the skin    Hair growth   c)  The musculature   d)  The behaviour of the endocrine glands    The thyroid gland    Atrophy of the thyroid    Cretinous goitre    The parathyroid glands   The sexual glands and the sexual organs    Hypophysis   e)  The intestinal tract and its glands   f)  The blood vascular system    Heart    Capillary structure   g)  The nervous system   Mobility    Neuromuscular system   Tendon reflexes    MacCarrison’s ‘Nervous cretinism’     Sense organs    Hearing disorders        Speech disorders    Autonomic nervous system  3.  The intellectual behaviour of cretins    Mental debility        Intellectual development    Acquisitive instinct   Imitative behaviour    Self-awareness    Emotions        Sociability    Gratitude    Sexual behaviour        Psychological functions in relation to body type VI.  Pathological anatomy and histology (Wegelin)  1. Thyroid gland    Epithelial changes    Sclerosis    Lymphocyte infiltration    Vascularization    Regenerative epithelial growth    Nodular goitre    Malignant epithelial goitr    Vascularisation of nodular goitre        Functional behaviour of the thyroid gland    Diffuse goitre    ‘Niduses’ of squamous epithelium    Dispersed aggregations of parathyroid cells and remnants of   the ultimobranchial body  2. Parathyroid glands  3. Thymus  4. Hypophysis  5. Pineal gland  6. Suprarenal glands  7. Gonads    A.  Male gonads   B.  Female gonads     Ovaries    Uterus                Breasts  8. Nervous system      Meninges     Brain    Spinal cord     Peripheral nerves   9. Musculature   10. The skeleton    General restriction in growth     Physical proportions     Development    Bone form relationships     Skull     Trunk     Upper limbs          Lower limbs  11. Joints  12. Teeth   13. Skin and subcutaneous tissue   14. Ear   15. Circulatory system    Heart    Arteries     Capillaries   16. Blood, and blood-forming organs      Blood    Bone marrow      Lymph glands      Spleen   17. Respiratory organs  18. Digestive organs      Tongue          Stomach and intestine     Pancreas      Liver      Gall bladder      Peritoneum   19. Urinary system   20. Further anatomical findings          Malformations    Blastoma      Tuberculosis    Syphilis 21. Lifespan and diseases of cretins     Average age    Causes of death   22. Cretinism in animals   23. Summary  VII.  Pathological physiology  (de Quervain)    Endemic thyropathy   Metabolism   Albumen and salt metabolism        Carbohydrate metabolism and basal respiratory metabolism    Blood examination    Blood clotting    Sedimentation rate of red blood cells    Dispersion grade of blood albumen bodies        Analysis of the individual fractions of albumen bodies in the blood   by weight determination   Phagocytic activity of leucocytes   Ion relationships in the blood    Iodine distribution among cretins   Analysis of the iodine level in the blood   Testing of thyroid gland function, after Asher-Streuli    Functional behaviour of the liver    Basedow appearance among cretins VIII.  Pathogenesis  (de Quervain and Wegelin)    Comparison of cretinism with congenital athyrosis, spontaneous   myxœdema and postoperative myxœdema        Scheme of possible influences of the goitre-noxa     Possibility of a dysthyrosis    Occurrence of thyroid gland atrophy    Congenital goitre among cretins   Comparison of the anatomical findings with those   of congenital athyrosis    Dissociation of symptoms    Different threshold values of thyroid gland function    Heredity    Goitre in the mother        Geographical dependence of goitre and cretinism    Inbreeding   Significance of local factors    Relationship with Status degenerativus   Question on the occurrence of genotypically-inheritable,   non-site-dependent diseases due to the goitre-noxa    Varying powers of resistance to the goitre-noxa     Goitre investigations in twins    Question about direct exogenous influence on the embryo     Possibility of direct exogenous influence of other endocrine glands   by the goitre-noxa    Nervous cretinism   Question on the inadequate functioning of the other endocrine glands    Occurrence of hearing disorders  IX.  Prophylaxis and Treatment of Cretinism  (de Quervain)    ‘Racial hygiene’        Improvement of the hygiene of living conditions    Radioactivity of the soil    Combating the goitre-noxa by iodine in small doses    Prophylaxis through iodised cooking salt        Iodine supplement during school age    Iodine supplement for the pregnant mother    The question of sterilization   Implantation of thyroid gland tissue    Substitution therapy with thyroid gland preparations    Iodine treatment    Goitre surgery among cretins    Goitre and cancer References Appendix