ATHYREOSIS ACQUISITA This affection is likewise described in the literature as, infantile myxmdenia, sporadic cretinism, ete. Its symptom complex comprises all manifestations of absent function of the thyroid, the latter or its secretion being completely missing in the congenital form.
We have seen from the inflammatory infections of the thyroid that these may terminate in complete atrophy of the organ, and similarly the total extirpation of the goitre in juvenile age has culminated in athyreosa acquisita.
According to the age and development of body and mind there will be varying pathological pictures with the onset of complete athyreosis. The later the disease sets in, the less pronounced will be the dwarfish growth of the body and intellect; the slower the organs decay, the less stormy will be the manifestations of absent function.
If the development of the osseous system is advanced, dentition complete, and a certain school education attained, the degenerative manifestations of secretion, hair, nails, inflated abdomen, umbilical hernia, will nevertheless appear, the mucous membranes will become involved, and intellectual retrogression is unavoidable: in short, there will be the well-known picture of myxceclema. But the former intelli
gence will not entirely disappear, speech will be paidly retained and a certain degree of general intelligence is demonstrable. The patient will make no further physical or mental progress, become blunted and apathetic, and, unless properly treated, will present the condition of thyreoaplasia of a comparatively more pronounced degree the sooner the affection has set in and the longer it has lasted. Where dwarfish structure is comparatively unimportant and the mental backwardness correspondingly slight, there will always be the suspicion of acquired loss of the thyroid, but the diagnosis will often be doubtful.
A complete set of teeth, closed fontanels, relative slight backward ness of physical size and skeletal development, demonstrable expressions of intelligence acquired not by mere training but by early acquisition, establish, in the presence of all the other manifestations of complete athyreosis, the diagnosis of acquired, as opposed to congenital athyreosis.