Factors Influencing Appearance of Centers of Ossification During Early Childhood

In a previous paper Werle and I¹presented a schedule for date and sequence of appearance of centers of ossification in young children. It is the purpose of this report to show how the epiphysial rating may be used as a measure of constitutional health and how specific disturbances affect the schedule. The centers at the wrist are particularly sensitive to disturbance and by their several stages of progress betray a previous disturbance in health. Roentgenograms of the left hand and wrist of each of several 5 year old boys, together with a brief health report on each, illustrate how the carpal area records fluctuations in health. The left hand of the first of these boys at the age of 5 years is shown in figure 2. The boy was weaned at 6 weeks, and there was considerable difficulty in finding a suitable substitute formula. During most of his