195 



The abnormalities found here belong in fact to the rarities, and 

 it was obvious that the combined occurrence of these abnormalities, 

 which in themselves are already rare, could not be regarded as merely 

 accidental. Consequently not 3 abnormalities existing beside and 

 independently of each other, but 3 consequences of one and the same 

 germinal defect. If this were indeed the case, (here should be one 

 point in the embryonal development from which these three systems 

 of organs differentiate. And now embryology teaches us that this is 

 indeed the case, and that they are all three products of the mesen- 

 chyme. We have now therefore put forward the hypothesis, that 

 toe have here to do icith an hereditary inferiority of the mesenchyme. 



The foregoing hypothesis is now supported : 



^4. By the results of a closer examination of the 3 patients. 



It appeared namely that in these patients still other products 

 of the mesenchyme showed abnormalities, which were either 

 congenital, or consequences of an inferiority revealing itself in abnor- 

 mally early wastage of the respective organs. 



So we find in the father (at the age of 54 years) : 



on both sides a very strong arcus senilis corneae; 



a leather strong sclerosis of the bloodvessels, though there were no 

 propitiating causes at work as lues, intoxications (lead, alcohol, 

 tobacco) or nephritis; 



a rectangular position of the two auricles with regard to the skull. 



In the elder girl the tivo little jingers -were in radial adductio7i 

 in the metacarpophalangeal joint. 



B. By the examination of the other members of the family. 



I could obtain information about 244 members of the family 

 extending over 5 generations (children that died very young, are 

 not included). Only the branch of my patient's father has been 

 included' in the scheme. Of these 59 children I myself could 

 interrogate and examine superficially 40. It appeared now that 

 already from my patient's grand-parents haemophily occurred in 

 this family, -and that there were several cases of blue sclerotics 

 and also of haemophily among the 59 individuals whom I included 

 in the scheme. Moreover there was one case of congenital defect 

 of the heart, one of split palate ivith harelip, one of rachischisis. 



This is of course the minimum of the existing abnormalities for I 

 could only make a thorough examination of a few of the 40 

 individuals whom I saw myself. Two cases of very severe rickets 



