138 INANITION AND MALNUTRITION 



weight due to persistent growth of the skeleton, have already been considered. 

 Certain further details as to structural changes will now be mentioned. 



A thorough histological study of the zone of enchondral ossification (upper 

 femur, etc.) in the full term fetus of rabbits subjected to total inanition for 2-8 

 days was made by Diatschenko ('97, '99). No data as to the effects of the 

 maternal inanition upon the fetal body are given, but marked and progres- 

 sive changes were found in the zone of ossification. The cartilage showed no 

 changes except in this zone, although some increase in the number of osteo- 

 blasts beneath the neighboring periosteum was evident. The hyperplastic 

 zone (columns of flattened cartilage cells) increases from 0.6 to 0.8 mm. in 

 width. The hypertrophic zone becomes indistinct, but the atrophic zone (of 

 regressive cartilage cells) increases from 0.12 to 0.23 mm. in thickness. The 

 atrophic cartilage cells are markedly shrunken, in rounded, strongly calcified 

 capsules, separated by thickened septa. 



The bony trabeculae in the adjacent marrow zone become slightly thickened 

 and covered by osteoblasts 2 or 3 layers deep, instead of the normal single 

 layer. The nuclei of the cartilage cells and the osteoblasts in the region stain 

 feebly, giving a characteristic light zone in stained preparations, which increases 

 progressively in width during the period of inanition. 



The newly formed bone laid down upon the trabeculae and walls of the 

 medullary spaces may present a somewhat thickened osteoid (uncalcified) 

 layer, but never the irregular osteoid masses characteristic of rickets. The 

 progressive changes produced in the fetal ossification zone are designated by 

 Diatschenko as " chondrodystrophia foetalis ex inanitione" and resemble some- 

 what those of syphilitic osteochondritis. They differ from those in rickets 

 especially in the increased width of the atrophic cartilage zone and in the inten- 

 sity of calcification. 



In a radiographic study of the skeleton in the hands and feet of children 

 retarded in growth by malnutrition, Variot ('05a, '06, '06a, 'oyd) found the 

 centers of ossification appearing nearly normal according to the height. Thus 

 the process of ossification is somewhat in advance of that in normal infants 

 of the same body weight, but is behind the normal for corresponding age. A 

 similiar condition was found by Jackson ('15a) in the skeleton of young albino 

 rats held at maintenance by underfeeding from 3 weeks to 10 weeks of age. The 

 persistent growth of the skeleton involves the normal appearance and union 

 of the various epiphyses, corresponding to the size or weight of the skeleton. 

 Unpublished observations upon sections of the lower end of the femur in these 

 rats by Dr. F. P. Silvernale, in the Institute of Anatomy, University of Minne- 

 sota, show an apparently normal process of ossification, with no indication of 

 the dystrophic changes observed by Diatschenko ('97, '99) in the rabbit fetus. 



In the cranium of athreptic infants, a depression of the fontanelles with a 

 tendency of the bones to overlap, so as to produce ridges at the sutural borders, 

 was noted by Tardieu ^80), Thiercelin ('04) and others. This may be due to 

 cranial overgrowth exceeding that of the brain, or to decreased intracranial 

 fluid. Dystrophic structural changes in the cranium of athreptic infants, 

 according to Lesage ('14), may involve a "soft atrophy," with retarded ossifi- 



