File:Cretinoid C.jpg

feet 3 inches ; weight 34j4 pounds. Clay-colored complexion ; pend- 
ulous abdomen ; head brachycephalic ; hair dark red, thick and fine. 
Face square, bridge of nose flattened, nostrils dilated. Tongue is 
large ; teeth badly decayed. Ears large and prominent. Eyes 
brown, set far apart. Circulation poor, extremities cold ; red spots 
on cheeks. Speech very defective and vocabulary small. Sluggish 
in habit. Gentle, amiable, affectionate, obstinate ; has a violent tem- 
per when roused. Powers of attention, imitation, and memory fair. 
Unable to wash, dress, or care for himself in any way. 

First-born, dry birth, premature, labor difficult. Fed artifi- 
cially during first month, then nourished by negro nurse for two 
weeks, and afterwards by mother. A sickly infant with defective 
heart; had a slight attack of meningitis when 6 days old, asso- 
ciated with spasms. During the first and latter months of preg- 
nancy the mother suffered from fatigue of journey, anxieties from 
proximity of yellow fever, and within a few weeks of delivery sus- 
tained a severe fright. Father 25, mother 23, at time of N.'s birth. 
Family history good. Environment not of the best — being a malari- 
ous district in the far south — an entire change was deemed advisable. 

Upon coming to me, he was placed at once on thyroid, 2j^ grains 
of the dried extract being administered daily in divided doses. The 
effect was immediate increase of temperature and loss of appetite. 
A gradual reduction, first to one half and then to one fourth of the 
quantity still producing very unpleasant effects, I was forced finally 
to abandon it. Extreme fragility of constitution gave no hope of 
resisting the rigors of a northern climate, and in fact, demanded a