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B. R. Sleeman, M.D.
JAMA. 1927;89(24):2060. doi:10.1001/jama.1927.02690240052031.
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To the Editor:  —I understand that the theory has recently been advanced that those monsters which have been thought to owe their origin to causes already existing in the germ (primary germ variation, inheritance, atavism) in reality have as their causative factor some endocrine disturbance on the part of the mother. With reference to these conflicting ideas, the following report may be of interest: Mrs. W. F., aged 34, at her fourth confinement, and two weeks before term, was delivered of twin boys. The first born of the twins was a pronounced micromelus with cretin-like facies. This boy lived about three hours. The second, born one hour later, was normally developed and is living and well. The approximate weights were 5¼ and 4¾ pounds (2.4 and 2.1 Kg.), respectively. These were double ovum twins; the placentas were entirely separated, and each placenta was extruded after the birth of the corresponding


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