The Author reexamines in current terms the old problem of Constitution from the medical viewpoint. Modern medicine, over the last 100 years, has mainly stopped to consider the importance of the diseases’ imprint of the phenotype as well as the diseases’ exogenous causes; today it is specially called upon to focus its attention on the deseases’ endogenous causes and on the individual’s morbid destiny. Constitutionally minded medical schools have surveyed this field from the morphological, functional and neuroendocrinological viewpoints, but with little practical result. Only by basing Constitution studies on the laws of Genetics will it be possible to solve the important problem from the clinical point of view.

The Authors have studied the case of abortive quintuplets born in Taranto, Italy, on June 15, 1952, as the ninth parturition of a 35 years old woman, with a history of twin heredity on the father’s side.

According to anamnesis and to objective examination, the fetuses appear to have five months of intrauterine life. On the basis of sexes (two males and three females) and of the annexes’ findings, the hypothesis of a trizygotic quintuplet set is suggested. Concerning the hereditary mechanism of twinning the Authors state that the genetic twinning factor (G factor) is not specific either by quality (MZ, DZ) or by quantity of the twins it produced.

As far as the age estimate of the twin fetuses is concerned, they state that the diagnosis, rather than on quantity data, is to be based on the quality ones, and specially on the ossification -nuclei detected by X-rays.

The A. reports some fundamental biological proceedings in a preventive treatment of hereditary diseases.

She divides prophylaxis in idiotypic and phenotypic and after having examined the different aspects of the problem, concludes that a positive eugenetica is possible by acting on environment disposing or exposing conditions. The A. finally indicates how studies should be carried on in order to attain this object.

Analysis of the statistics of multiple births in England and Wales between July, 1938 and December, 1945 proves that the frequency of monozygotic twin births is virtually constant, at about 3 per 1000 pregnancies, for all ages of mothers. The frequency of dizygotic twinning, however, increases with maternal age from 2 per 1000 pregnancies at 17 to a maximum of 14 per 1000 pregnancies at 38, and then decreases gradually to 5 per 1000 maternities at 45. Comparison of the average numbers of previous children to mothers at each age shows that the twin pregnancies were associated with a greater number of previous children then were the single maternities. While the reasons for this difference cannot be deduced from this data, if the tendency to multiple births is governed entirely by heredity and is independent of a woman’s parity, this greater number of previous children to mothers of twins vould indicate that the probability of repetition of a twin birth is ten times as large as he total population frequency of twins births.

Though conception and reproduction have been favorite topics of the biologists of all ages many of the simplest facts of generation are still lacking their proper explanation. They remained mysteries and stimulated wild speculations not only among the uneducated people but also among the physicians, naturalists and others engaged in the scrutiny of Nature.

1. The uses of twins as a tool to estimate heritability are reviewed.

2. Comparisons of dizygotic twins with sibs provide a means of estimating how effective conditions in utero common to both types of twins may be in producing intra-pair differences.

3. Genetic variations in plasticity should be taken into consideration in the interpretation of data obtained from twins.

4. Methods for testing simple modes of inheritance by information obtained from dizygotic twins are reviewed.

The Authors from the examination of a group of pedigrees belonging to subjects with allergopathies conclude that in their observations allergopathies behave like monomeric dominant forms with little penetrance. Afterwards they propose an explanation of the relative excess of sick persons in the discordant marriages and of the remarkable incidence of pollinosis.

We describe a fortuitous observation on two rats united in parabiosis since nearly a year.

One of the two, belonging to an oncoreceptive race, fell sick of a round cell sarcoma, of extremely malignant nature, which spread itself through various metastases to all the organism, invading especially the lungs and causing tha animal’s death.

The other, of oncorefractory race, did not fall sick, although he was united to the first by abundant vascular and lymphatic communications, and that the common abdominal cavity was full of an hemorrhagic exsudation containing numberless cells coming from the tumorous decomposition. As the question is of a parabiosis of long duration and of a natural tumor of great malignity, the observation, better than the preceding ones on grafted tumors, favours the demonstration of the importance of the individual constitution of a subject sick or not of cancer.

After some brief considerations about the etiopatogenesis of the hereditary deafness, and the modern classification of its different nosologic pictures, the AA. pass on to consider four cases of female sex, two sisters and two cousins of mother side, with hereditary familiary deafness, apparently boun to the sex. All the four cases are characterized by the identity of the audiometrie findings, after the « Law of the symmetry of the hereditary deafness ».

The AA. discuss at least the modality of the hereditary transmission and the anatomopatologic picture of the morbide form.

The typical picture of mongolism has been observed in both members of a proved monozygotic twin-pair, aged 15. There is no indication in the family history of any hereditary predisposition, and both, the pregnancy and the birth were quite normal. The author reviews all cases previously reported, and expresses the opinion that mongolism is due to some phenomenon occurring during the germinating period, that is to say during the initial stages of development of the egg.

Under the name of “Progenesis” (from the prefix “pro “, in front, and of the Greek “genesis “, generation) a new conception and classification of the factors of development were proposed by R. Turpin, the progenesis grouping “the whole of the hereditary and non hereditary factors that preexist to the fecundation and that concur to the formation of the being and to its development”.

This conception has the advantage of designating indifferently, to all progenitic factor, hereditary as well as non hereditary, a place marked in advance; it has the advantage of showing beside the paternal maternal factors, the characteristic progenetical factors of the couple; it has the advantage to draw the attention on factors which were before neglected (age of mother, age of father, rank of birth, sex of the preceding pregnancy, interval between pregnancies, number of pregnancies, etc.) and whose importance increases in proportion as the gathering of the facts is abundant enough to lend itself to the statistical analyses; it has lastly the advantage of leading to an etiological prevention of the congenital defects, trying to draw the most advantage from the surrounding factors, without discarding, when they are imposed by the circumstances, the possibilities brought to their right proportion of the eugenic selection.

To illustrate this progenesic conception of the ontogenesis a simple example, the gemellity, deserves to be retained.

If we consider the gemellity as a deviation in regard to the simple pregnancies, it constitutes at the same time the more frequent and the best registered of anomalies. It lends itself to the study of its relations with divers progenesic factors which the authors regard by turns with the complement of their personal researches : age of the progenitors, rank of the pregnancy, sex of the product of the anterior last conception.

If on the other hand, we consider the gemellity itself as a progenesic factor, we can study on the development, and for instance, which the authors have done, on the rate of masculinity. This study has lead them to put in value the phenomenon of diminution of the masculinity in relation to the degree of the multiplicity of pregnancy.

The Autors show a case of research of maternity in the subject of alteration of social condition in comparison of two newborns, this is a case in which a maternity staded could be excluded, and a maternity denied could be recognized, on the base of the genotypes in connexion to the qualities of the specific-groups Rh.

The gynaecological exam of the two women and the determination of the types ABO and MN had not allowed the complete solution of the problem which was, on the contrary, reached and showed by the acknowledgement of the genetics formulas Rh.

Report of a case of unilateral aplasia in mirror-image form of the kidney and the corresponding ureter in monozygotic male twins.

To demonstrate the effects of home environment and parent-child relationship on personality and development, the author tells the life story of a pair of monozygotic twin girls reared apart. One, who grew up as a member of a large closely-knit family group, with mother-love and parental security, has become well-adjusted and happy in spite of severe set-backs. The other, reared as an only child by a hard and restrictive step-mother, and always required to do much hard work, became a tense and instable person, addicted to drugs and Anally probably committed suicide.

An old problem of gemellary research lies in the determining cause of gemellogenesis. Two new observations of the family order, in agreement with other similar results, are further evidence in favour of the opinion that in the origin of twins a certain part can be played by some hereditary property of the paternal side.

Gemellary research is the best method to establish the respective importance of heredity and environement in the developement of man. A new problem of gemellary research has arisen owing to the fact that MZ twins can differ in some illness, without the common causal analysis heredity-environement being able to give a satisfactory explanation. For example in the case of cancer it is demonstrated that the “autonomous” genesis of an illness must be taken into account i. e. without an appropriate hereditary cause or without an esogenous cause visible for all. Such an “autonomous” genesis of an illness has become undestandable only on the basis of microphysical knowledge.

Description of 3 cases of identical twins affected by concordant oxycephaly. In the first case, one of the twins had a son who was likewise afflicted by a typical scaphocephaly. In the second case, both children showed also a convergent concomitant strabismus, which was latent in one and manifest in the other, and moreover a concordant ptosis. In the third case, the oxycephaly was associated with cutis frontis gyrata homologous in both twins.

A confrontation of the cases of oxycephaly in identical twins based on the literature and our personal cases, shows clearly a majority in favour of concordance : 25 concordant pairs as compared to 10 discordant ones; the fraternal twins (7-8 cases) are all discordant as regards oxycephaly. The cases of discordant oxycephaly in monozygotic twins must therefore be interpreted as the result of an unstable gene of feeble penetrance. The conclusion of the genotypic origin of oxycephaly is corroborated by some pedigrees showing a transmission through 2 or more generations. Two reported cases with consanguinity of the parents suggest likewise the possibility of recessive inheritance.

The association of oxycephaly with cutis frontis gyrata, as observed in our third case, having not yet been described, we cannot for the moment decide whether this combination is due to chance or whether there exists a pathogenic correlation between both anomalies.