Thyroid medication during childhood will be discussed under two headings: (1) substitution therapy in definite thyroid insufficiency and (2) the administration of thyroid in borderline conditions of questionable thyroid origin, in supposedly mixed endocrine disturbances and in conditions not hypothyroid in which the physiologic effects of the drug are sought. It is necessary first to mention briefly the diagnostic problems of hypothyroidism in childhood.
THE DIAGNOSIS OF HYPOTHYROIDISM IN CHILDHOOD
The untreated cretin of more than 2 or 3 years of age usually presents a picture which is well known and easily recognized.1 The patient is dull, listless and apathetic. The body is short and stocky. The cretinoid facies is characterized by coarse, heavy features; small, widely spaced piglike eyes with puffy lids; a broad, short nose with undeveloped bridge; a broad mouth with thick lips, and a broad protruding tongue. The skin is dry, thick, wrinkled and