Department of Orthodontic Abstracts and Reviews

Edited by
DR. J. A. SALZYANN, NEW YORK CITY

All communications concerning further information about abstracted material and the accept-
ance of articles or books for consideration in this department should be addressed to Dr. J. A.
Salzmann. 651 Madison Avenue, New York City.

The Grid for Evaluating Physical Fitness (Wetzel). Application to Children

With Abnormal Bodily Dimensions : By Hilde Bruch, J. A. M. A. 118 :
1289-1293, April, 1942.
In a recent publication Wetzel described a new method for evaluating
physical fitness which permits the estimate of different aspects of the physical
progress of a child from infancy to maturity. The assessment is based on the
use of a grid and demands only three simple routine measurements, namely
height, weight, and age. Wetzel enumerates eight different items which may be
determined from the grid : physique (body build), developmental level, nutri-
tional grade, physical status, relative advancement or retardation, maturation,
basal heat production and daily caloric intake.
The present report is intended to illustrate the application of the grid
chiefly in obese children. Cases of pronounced undernutrition and of retarda-
tion or acceleration of statural growth are included for contrast. The value
of the method for recognition of abnormal physical status and for evaluation
of therapeutic results could be confirmed. However, some limitations of the
method, which were not clarified in the original report, have been observed.
The construction of the grid permits the recording of height and weight by
a single point. The area of normal progress is divided into several channels.
If subsequent measurements follow the course of one of the established channels,
it may be concluded that the child is healthy and is progressing normally. A
slope of the line smaller than the slope of the grid indicates satisfactory progress
and improvement of the condition. A parallel curve of the line or a slope
larger than that of the grid is an index that the condition is stationary or is be-
coming worse. The grid thus offers a convenient guide for the evaluation and
adjustment of treatment in children with abnormal nutrition.
The values for ’ ‘ developmental age ” calculated according to the grid are
not in proportion with the actual biologic development of the obese child. The
discrepancy is the more pronounced the higher the percentage of overweight.
The grid for evaluating physical fitness (Wetzel) was applied to 52 chil-
dren with abnormal bodily dimensions. The usefulness of the new method for
the graphic recording and early recognition of abnormal changes in the height-
weight relationship could be confirmed. The grid appears to be of value for
the appraisal of therapeutic results. The relative advancement ‘or retardation
of statural growth (“height age”) can be readily assessed with the aid of the
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auxodromes. The deviation of the “developmental age” could be directly re-
lated to the abnormal physical dimension.
It was considered necessary to point out the limitations of the new method
in order to bring into clearer relief the true usefulness of the method. It is to
be expected that the application of the grid in public health work, school exam-
inations, and so on will render valuable service in screening out children with
abnormal body proportions and disturbances in developmental progress. For
the diagnosis, however, of the underlying disturbance in such children, and for
the prediction of future development and maturity, the assessment of “develop-
mental age” and also of basal metabolism additional information is required.

Hereditary Ectodermal Dysplasia of the Anhydrotic Type. A report of two

cases: By Harold Stadler, M.D., and Clarence Harlow Blackstone, D.D.S.,
J. Pediatrics 21: 229-237, August, 1942.
Hereditary ectodermal dysplasia of the anhydrotic type is characterized
mainly by the absence of the sweat and pilosebaceous glands, dental dysplasia,
depressed nasal bridge, atrophic rhinitis, prominent supraorbital ridges, and
thick, protrusive lips. The skin has been described as thin, glassy, smooth,
and dry, with papular lesions; also these individuals show a marked intoler-
ance to heat.
A report is made of two children who have hereditary ectodermal dysplasia
of the anhydrotic type and of a third child who shows only anodontia and
alopecia of this syndrome. The three children are closely related. The two
children with the complete syndrome are first cousins; the child with the
partial syndrome is a sister of one of the two children with the complete
syndrome. Siblings of the two mothers are affected; however, the two mothers
are normal. It is probable that the disease was transmitted through a maternal
carrier state.
In Case 1 described by the authors physical examination showed the
nutritional state to be good, The skin was peculiarly white and the hair was
scanty. The frontal bosses were prominent and the nasal bridges depressed.
While the patient cried a great deal, tears were absent. The nasal mucous
membrane was dry and crusted. The lips were thick and protrusive and the
buccal mucous membrane was dry. Eight teeth were present, four deciduous
molars, and four deciduous incisors; only two teeth, deciduous molars, were
present in the lower arch. All teeth showed coronal constriction toward the
morsal surfaces. Tonsillar hypertrophy was of moderate degree.
When this patient was aged 11 years, the frontal bones were prominent,
and the nasal bridge depressed. The lips were thick and protrusive. The
mucous membranes of the mouth and nose were dry, and moderate nasal crust-
ing was present.
Fourteen teeth were present, eight in the maxillary arch and six in the
mandibular arch. All the teeth were conical in shape. Roentgenograms re-
vealed one mandibular molar and two mandibular incisors that were forming
but were as yet unerupted, making a total of seventeen teeth. Moderate ton-
sillar hypertrophy was noted as well as a mild degree of cervical lymphade-
nopathy.