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7. Associated Ocular Defects.— Nine children had ocular
defects or defects of vision :—
Double optic atrophy 1
Ptosis and contraction
of right pupil 1 (Refused treatment)
Myopia 2
Other errors of refraction
5
Causation.— What causes the disorder of metabolism resulting
in the excessive deposition of fat in these children ? Is it due
simply to disproportion between the food intake and bodily activity
or is it due in every case to under-activity of the thyroid or pituitary
(posterior lobe) glands ? I am inclined to think that many of the
cases are the result of errors of diet and modern methods of living
but cannot confirm this without more reliable information as to the
children's habits. According to the parents' history— for what
it is worth— many of these children are not large feeders, but some
of them are large eaters of sweets and farinaceous foods. Children
get less bodily exercise year by year. They spend long hours in
school and in the majority of cases have no walk to get there, or if they
have, are conveyed, and moreover, apart from school more children
make use of omnibuses or private cars than formerly. On the
other hand, this will not account for the general overgrowth of
tissues in most of thecases. Presuming that there is dysfunction of
the thyroid or pituitary glands, what factor in our method of
living during the past ten years is responsible for the upset of the
endocrine balance ?
Symptoms.— The chief complaint is breathlessness on exertion,
but as most of the children are slow in moving, even this is seldom
complained of.
Treatment.— Four children were treated by dietary and
glandular extracts, either by the family doctor or at a hospital.
Two of these cases attended irregularly and increased greatly in
weight during the year. My experience in former years suggests
that these cases can be much improved if the treatment is regularly
and conscientiously carried out. In 1935 only three showed a
marked improvement. In one of these cases the obesity was
definitely of pituitary origin. At 12½ years this boy weighed
11 st. 12 lbs., and he had associated genital changes and marked
enlargement of breasts, probably due to dysfunction of anterior lobe.
He was very dull and was unable to read at all. His mentality
improved rapidly under treatment, and after five months he could
read well.