An exception must, however, be made of conditions due to insufficient secretion of certain glands. The type of these is cretinism. Marked cases of this condition are easy to recognise. The very appearance of the children is sufficient for an experienced eye--the stunted growth; the rough, wrinkled skin; the swollen eyelids half-concealing the eyes; the prominent belly; and the mental apathy. One also comes across abortive cases, where the above-mentioned characters are less marked; the sluggishness also is less. These latter cases are amenable to the same treatment as the former--namely, the ingestion of thyroid glands from the sheep. This treatment stimulates growth and makes the child more lively; but what ultimately becomes of the cases so treated? The amelioration usually ceases whenever the treatment is dropped. But how far does this amelioration go? To what extent does the child profit by it? Lasègue has jocularly remarked that the average duration of an attack of typhoid fever (six weeks) represents the maximum time during which medical attention could be brought to bear upon a patient. One feels disposed to think he is right in face of the slight satisfaction one can obtain from the literature regarding a point of such importance. Other cases of mental deficiency may be due to an alteration in the pituitary gland. It is for the doctor to find out whether there are any symptoms by which mental deficiency of such an origin can be recognised, and whether it is possible to prepare a suitable substance for replacing the absent secretion. The number of cases amenable to treatment of this kind is, unfortunately, very limited.[13] We may even say that, as a general rule, we did not find amongst the school children we examined any cases of obesity or infantilism such as are sometimes described of a truly remarkable nature. Even children who were abnormally short looked their age. We have still, however, to mention one last influence--namely, poverty. Its part in the production of mental debility is scarcely defined. What are the exact effects upon intelligence of prolonged deficiency of nutrition? How can its action be isolated from that of other agents, such as alcoholism, which too frequently accompanies it? The complexity of such social studies sufficiently explains their present incompleteness. Let us recall the results we obtained from an inquiry of this kind; the children of parents in extreme poverty are retarded in their physical development more frequently than those whose parents are in easy circumstances. It is interesting to add that analogous inquiries with reference to intelligence have furnished similar results.