1890-91.] Drs Symington & Thomson on Defective Ossification. 271 
A Case of Defective Endochondral Ossification in a 
Human Foetus (so-called Cretinoid). By Johnson 
Symington, M.D., and Henry Alexis Thomson, M.D. 
(With Three Plates.) 
(Read June 15, 1891.) 
We have ventured to bring our examination of this specimen 
under the notice of the Society, not so much for its pathological 
interest, as for the light which it throws upon the normal mode of 
growth of the skeleton. There has been a tendency of late to regard 
endochondral ossification as quite secondary in importance to that 
of membranous ossification, hut we believe that the case illustrates 
in a very striking manner the important part played by ossification 
in cartilage in the growth of the greater part of the skeleton. 
The specimen is a female foetus, which we received last February 
from Dr Gronin of Pontypool. It was horn at the full time, and the 
labour was natural, except that the liquor amnii was in great excess, 
and that the forceps were used to assist the progress of the head. 
The father is a healthy man, aged twenty-six years. The mother, 
who is a year or two younger, suffers from occasional fits, regarded 
by her doctor as epileptic. They have two healthy children, aged 
four and two. About three months before this, their third child, 
was horn, the mother was violently assaulted by another woman. 
There is no history of any relative of the parents having suffered 
from any malformation of the skeleton. 
The foetus weighed 8 lbs. 2 oz. Its general external appearances 
are shown in Plate I., which is the reproduction of a photograph 
taken by ourselves. The most striking feature is the shortness of 
the upper and lower extremities, which are not only greatly 
diminished in length, hut are very thick, and marked by deep 
transverse sulci. The head and trunk, on the other hand, are of 
nearly normal size. A closer examination of the head shows, 
however, a few peculiarities. Thus its upper part is somewhat 
enlarged, and the fontanelles are abnormally open. There is a deep 
sulcus at the root of the nose, 'which is exaggerated by the forward 
bulging of the forehead ; the nose itself is short and thick. This 
appearance has been described as resembling that of a bull-dog. 
