Blood studied in a case of congenital myxcedema treated with thyroid. The diameter of the red corpuscles before the treatment began was 3.13 microns; afterward it was 7.5 microns. At the same time the appearance of nucleated red corpuscles was observed, which dis appeared under treatment. It would appear as though the persistence of the ftetal state of the blood coincided with the tardy development of the body. Lebreton and Vaquez (La France Mod. et Paris Mod., Jan. IS, '95).
[Koplik (N. Y. Med. Jou•., vol. lxvi, No. 10) says: is an interesting fact that in this case, early in the disease, the hemoglobin was greater than later on, though the infant was immediately placed upon thyroids." This would seem to point to the fact that the anemia of cretinism develops as the disease pro gresses, and is not present at the initial stage of the disease.
Vaquez (Le Progres Mild., Mar. 20, '97) found "merely a condition of anre mia, with presence of nucleated red cells; there appeared to be augmenta tion of the globular diameter" (first noted by Kroepelin); he did not find any leucoeytosis, but there was an in crease of the large mononuelears rela tively to the number of polynuclears, after treatment with thyroid.
Pollaci (La Riforma Med., vol. ix, Oct., '97), who has studied the blood in cretinism more carefully than any other observer, draws the following con clusions: 1. The blood of these two myxcedematous cretins presented the physio-histologieal characteristics of a common simple secondary anaemia; in different degree a single characteristic distinguished this oligsemic condition from similar conditions of oligremia met with in other diseases—that was the presence of megalocytes. 2. Digestive leueoeytosis had no special character istics which distinguished it from ali mentary leucocytosis studied in other diseases.
Foerster (Dent. med. Woch., Nos. 12, 13, 16, '97) does not mention the pres ence of megaloeytes, but says that "there is generally a slight diminution of the reds, with deficiency of luemoglobin; as regards the whites they may or may not be increased, probably generally not.
With reference to the different forms of white cells, there are not sufficient studies to express any definite opinion, as the findings have varied." WILLIAu Osi.xa and Ilmirr Noirrox.] On other pathological conditions ex isting in cretinism not enough is known to report definitely, but a few of them may be mentioned. Curvature of the spine occurs in some cases, though not in any large percentage. Some observers have noted hypertrophy of the pituitary body after thyroidectomy on animals; but nothing can be stated as to the mean ing or importance of this fact. Excess of cement in the heart, which was first described by Ord, was not found by Ness (Glasgow Med. Jour., Aug., '97) in his case.
[Langhans (Virchow's Archiv, B. 149, H. 1, '97) found exactly the same con dition of the ovaries as Hofmeister did in his experiments with Lc., a marked degeneration as shown by the presence of numerous small cysts. The testicles, according to this author, were neither macro- nor micro- seopically normal; they were small and contained but few spermatozoa. Maffeo, and Stahl have described this same atrophic condition of the testicles. The have been most ex haustively studied by Langhans (Vir ehow's Archie, B. 149, H. 1, '97), but, as he says, they have been previously so little studied that the change he found in them in cretins cannot be definitely stated to be characteristic; yet the alterations in them from the normal were so marked that he believes they are one of the stigmata of this dis ease; the changes seem to consist of an exfoliation of the lameihmn of the spindle, with a deposition of mueinoid granules in the spindles, and an increase of con nective tissue running through them.