[Footnote 3:  If we accept as hysterical all symptoms which are produced by suggestion and which can be removed by suggestion, we may correctly speak of a physiological hysteria of childhood, which includes a very large number of the symptoms discussed.  The term is used here in its older more limited sense.]

(1) A GROUP WITH PERSISTENCE OF CERTAIN INFANTILE CHARACTERISTICS

During the first year or eighteen months of life, the rounded infantile shape of body persists.  The limbs are short and thick, the cheeks full and rounded, the thorax and pelvis are small, the abdomen relatively large and full.  The great adipose deposit in the subcutaneous tissue serves as a depot in which water is stored in large amounts.  In the healthy child of normal development by the end of the second year a great change has taken place.  The shape of the body has become more like that of an adult in miniature.  The limbs have grown longer and slimmer.  The thorax and pelvis have developed so as to produce relatively a diminution in the size of the abdomen.  The body fat is still considerable, but no longer completely obliterates the bony prominences of the skeleton.  Delay in this change, in this putting aside of the infantile habit of body, is commonly associated with a corresponding backwardness in the mental development.  Such children walk late, talk late, learn late to feed themselves, to bite, and to chew effectively.  Watery and fat, they carry with them into later childhood the infantile susceptibility to catarrhal infections of the lung, bowel, skin, etc., and they are apt to suffer, in consequence, from a succession of pyrexial attacks.  Nasal catarrh, bronchitis, otitis media, enteritis, eczema, urticaria papulata, are apt to follow each other in turn, giving rise in many cases to a persistent enlargement of the corresponding lymphatic glands.  The effect upon the different tissues of the body of these repeated infections is very various.  We are probably not wrong in attributing the failure to develop and the persistently infantile appearance to a prejudicial effect upon the various ductless glands in the body.  The condition is associated with an excessive retention of fluid in the body, secondary in all probability to alterations in the concentration and distribution of the saline constituents of the body.  A rapid excretion of salts may be followed by a correspondingly speedy dehydration of the body, a retention of salts by a sudden increase of weight.  The parathyroid glands are probably closely concerned in regulating the retention and excretion of salts, and especially of calcium, a circumstance which becomes of significance when we remember how frequently rickety changes, tetany, and other convulsive seizures form part of the clinical picture which we are now considering.  While it is difficult to determine the effect of repeated infections upon the functions of the endocrine glands, we have clear evidence of the deleterious influence upon almost all the tissues