850 PETER BASSOE 



Chondrodystrophia Fetalis. (Achondroplasia). This curious con- 

 dition of micromelic or short-limbed dwarfism is as clear cut and uniform 

 clinically as its etiology is obscure. The chief features are: 1. Short 

 arms and legs. 2. Trunk of normal size. 3 Relatively large and brachy- 

 cephalic head. These features exist at birth, in fact they are present 

 early in fetal life. The condition is frequently hereditary and familial. 

 The muscular system is strongly developed, hence these dwarfs frequently 

 distinguish themselves as athletes and acrobats. It is thought that the 

 dwarf gladiators of the Roman emperor Domitian were of this variety 

 as their statues which still exist represent them with the typical short 

 extremities (Wagner). Their mentality is usually good. Among other 

 rather constant features are a deep insertion of the nose with antero- 

 posterior shortening of the base of the skull due to the small size of the 

 "os tribasilare," lumbar lordosis, and abnormal shortness of the fourth 

 fingers and toes. The latter feature particularly has been emphasized by 

 E. Levi (?>). The enlargement of the head in these dwarfs has recently 

 been studied by W. E. Dandy and attributed by him to slight and station- 

 ary hydrocephalus. 



G. A. Wagner emphasizes the tendency to early and excessive de- 

 velopment of the genital organs and their function a veritable hyper- 

 genitalism. To the latter he ascribes an important and primary role in 

 the etiology of the condition. He presents the contrast between eunuchs 

 and chondrodystrophic dwarfs as follows: 



EUNUCHS CHONDRODYSTROPHIC 



DWARFS 



Skull dolichocephalic. Skull bracliycephalic. 



Increased growth in length of the Abnormally short extremities. 



extremities. 



Epiphyseal lines remain open ab- Frequently premature closure of the 



normally long. epiphyses. 



Wagner is not certain whether the bony growth is directly modified 

 by the excessive gonad activity or through interaction by other endocrin 

 glands. The hypergenitalism is thought to cause the excessive muscle 

 activity which in turn is an important factor in inhibiting growth in 

 length. A similar theory of gonad overactivity has previously been sug- 

 gested by others (Parhon, Shunda and Zalplachta). 



Less plausible is the theory assigning the main role to the hypophysis, 

 which has been advanced, among others, by Baumel and Margaret, who 

 were much impressed by the adiposity of a patient described by them. 



All endocrin theories of this condition, however, are denied by many 

 observers. Osteochondritis in early fetal life from toxic-infectious causes 

 (Porak arid Durante), faulty mechanical conditions causing pressure on 



