32 THE ROYAL SOCIETY OF CANADA 
the literature, the thyroid gland was found to be grossly altered, 
usually absent or atrophied: in one case hypertrophied. In the 
non-cretinoid cases the thyroid was unaltered, so far as one could 
judge. 
Opposed to these considerations, it has been advanced that the 
distribution of the lesions in chondrodystrophia indicates that this 
affection originates from the third to the sixth week of intrauterine 
existence, at which time the thyroid is not properly formed. And, 
again, that thyroid feeding has not proved beneficial in these cases. 
This latter argument, however, fails to carry much weight if we hold 
that in chondrodystrophia we are dealing with a completed patho- 
logical process, completed, that is to say, in utero. Specific medication 
could not, therefore, be expected to produce any effect. So far as 
one can judge, without more extended information, it seems likely 
that the cretinoid type of chondrodystrophia is really ‘‘fœtal cretin- 
ism,’ while the other forms are not. In our own case, described 
above, there is little to identify it with cretinism, unless possibly 
the retracted nose, the large head, wide mouth, and defective denti- 
tion, yet in my judgment these are not important enough to bear 
this interpretation. 
We may pass on now to the consideration of two other factors 
which have an undoubted bearing on the question of dwarfism of 
this type, viz., heredity, and intrauterine pressure. 
The influence of heredity generally in perpetuating anotomical 
and other familial peculiarities is too well recognized to need en- 
larging upon here. Polydactylism may be cited as a case in point. 
It is, however, a curious and striking fact that some of these heritable 
conditions have been found to be associated with chondrodystrophia. 
Thus, Bowlby! reports a case with cleft palate, a deformed nose, 
and polydactylism of the feet. In our own case, syndactylism in 
one foot was exactly paralleled in the person of a maternal uncle. 
Theodore Kerckring in a work entitled, ‘“‘Spicilegium Anatomicum,” 
published in 1670, figures a micromelic dwarf in whom there was 
polydactylism of both hands and both feet. Porak? records a case 
in which a dwarf gave birth to one healthy child and another present- 
ing all the features of so-called ‘foetal rickets.’’ 
Guéniot? recounts the operation of Cæsarian section on an 
achondroplastic dwarf, the child being similarly affected. Clearly, 
heredity may on occasion play an important role. Yet, on the other 

1 Trans. Pathological Society, 1884, p. 450. 
? Beitrag zur Histologie u. Funktion der Schildruse, Inaug. Diss., Koenigsberg, 
1892. 
° Bull. et Mém. de la Soc. Obstetr. et Gynécol. de Paris, Jan., 1893. 
