[NICHOLLS] CHONDRODYSTROPHIA FŒTALIS 33 
hand, the parents of achondroplastics may be perfectly formed, 
and their children may be normal. 
Intrauterine pressure is, also, as clearly associated with anoma- 
lies of development. Klebs! records a remarkable case of this kind. 
In an ectopic gestation the foetus was found in a tight sac within the 
transverse mesocolon. There was syndactylism in the upper extrem- 
ities and polydactylism in the lower. From a study of the recorded 
cases it would appear that contraction of the amniotic sac does not 
lead to stunting of the body as a whole, but that certain parts such, 
as the extremities and head are more apt to be affected. It is sugges- 
tive that in our case, there was probably hydramnios in the mother, 
and one of her former children died with spina bifida shortly after 
birth. It is known that hydramnios is not infrequently associated 
with grave deformities, among which may be mentioned exencephaly, 
spina bifida, and osteogenesis imperfecta, this last-mentioned condition 
being found also, though rarely, with chondrodystrophia. In this 
connection it may be mentioned that in Klebs’ “General Pathology” 
there is an illustration representing a microscopical section through 
the growing end of one of the long bones of a micromelic dwarf. 
The cartilage cells here are closely packed and flattened with their 
long axes at right angles to the long axis of the bone, an appearance 
that could hardly be attributed to anything else but pressure. 
In the case cited in this paper, it is difficult to attribute the striking 
anomaly of development to intrauterine pressure, to the exclusion 
of hereditary influences. The syndactyly was clearly a Mendelian 
character. Nor, indeed, is it necessary to exclude either factor. 
For even if we conclude that the condition was due to intrauterine 
pressure, the result of hydramnios, the tendency to hydramnios 
itself may have been handed down from some ancestor. On the whole, 
the view of Virchow seems to be more in keeping with the facts as 
we know them. This great pathologist pointed out that the condition 
of chondrodystrophia gradually shades into a more pronounced 
developmental anomaly, which is finally represented by the phoco- 
melia of Saint Hilaire. He objects to the term chondrodystrophia, 
introduced by Kaufmann, on the ground that the obvious errors in 
development that are sometimes associated with this condition 
can only be explained on the basis of some peculiarities of the ‘‘Anlage.”’ 

1 Textbook, p. 306. 
Sec. IV, Sig. 3 
