A short comparison of athy reosis and mongoloid idiocy may illustrate the differential diagnosis between both affections. The growth of the mongoloid patient is only arrested in later years, if at all; he shows obesity instead of myxcedema.
As early as the second year of life Ile loses his apathy of mind and body peculiar to myxidiocy, he will have a normal set of teeth at a much earlier time, learn to walk earlier, grow row+ more rapidly, and never show later the repulsive, animal-like expression of the athyreotic patient. He perspires normally, the latter never; he laughs, makes grimaces, imitates everything, enjoys music, is affable and exceedingly lively, all of which is absent in myxid iocy. His skeletal development is normal, while the latter remains on the level of an infant. He is insusceptible to all therapy, while the latter under the influence of organotherapy makes months of progress in a few weeks, years of progress in as many months. The treatment of mongoloid idiocy lies in the hands of the pedagogue; that of in3rxid ioey in the hands of the physician.
In those. symptoms of mongolism which are related to dysthyreosis, thyroid medication is likewise successful. The adipose tissue, the changes
of the mucous membranes (conjunctivitis, ad e noi ds), constipation, umbilical he, nia, often also arrested growth and delayed denti tion, the defective hair, and occasionally the eczema, yield to organotherapy much more slowly and with less apparent effect. Where, however, demonstrable dys thyreosis is present as a COM plication in a mongoloid patient, there is brilliant and rapid success, while relapses are very slow and imperfect in appearance. This corresponds to the fact that dysthyreosis of mon goloids begins to abate to ward the end of the first or latest in the second or third year. Figs. 137 and 13S will show to what extent a cure may go.
The prognosis is un f a vora ble, a cure is ex cluded, the possible im provement is slight :Ind rapidly reaches its maximum. In the majority of eases death in early childhood from pulmonary affections, especially tuberculosis, will occur, although in every asylum there are always mongoloids of forty or fifty years of age.