Figure 2.

Sporadic cretinism in a 4-year-old girl, before (left) and 2 months after starting treatment with thyroid extract. Note the myxoedematous swelling of the whole body has almost entirely disappeared with treatment, the tongue is no longer protruberant, the expression is much brighter and the child is taller. The photographs have been reproduced exactly to scale so that the relative increase in height and diminution in girth before and after treatment are reliably shown (from Bramwell 1895)