Bauhaus-Universität Weimar

Titel:
The Cyclopaedia of Anatomy and Physiology, vol. 2: Dia-Ins
Person:
Todd, Robert Bentley
PURL:
https://digitalesammlungen.uni-weimar.de/viewer/image/lit25760/340/
332 
FŒTUS. 
found in the foetal lungs a calcareous concre¬ 
tion. 
Pleuritis.—The effects of inflammation at¬ 
tacking the pleura before birth are not unfre- 
quently seen. Billard relates the case of a 
child which died on the fourth day after birth, 
in whom the pleura was found greatly thick¬ 
ened, and there were existing between its oppo¬ 
site surfaces bands of adhesion as firmly orga¬ 
nized as those found in an adult, eight or ten 
years after a pleurisy.* 
In a case described by Cruveilhier, the child 
died thirty-six hours after birth, and there was 
found double pleurisy with effusion of a sero- 
lactescent pseudo-membranous fluid; and in 
another instance described by the same writer, 
in addition to anasarca, ascites, and purpura, 
there existed hydrothorax, in a seven months’ 
child, which had lived only twelve hours :+ 
other instances are related by Veron, Orfila, 
and others. 
Purulent effusion.—The formation of pus 
has been frequently observed in the foetus, both 
in the form of secretion from the lining mem¬ 
branes of cavities, and in distinct circumscribed 
abscesses. 
In cases of pleuritis and peritonitis, as alrea¬ 
dy noticed,| the abdominal and thoracic cavi¬ 
ties have contained sero-purulent fluid. Cru¬ 
veilhier found pus between the dura mater and 
skull in a still-born child.§ 
Abscesses have been found in the thymus 
and thyroid glands and in the supra-renal cap¬ 
sules, see p. 334 ; and Andral found several in 
one luug.|| 
Ollivier (d’Angers) has given an account of 
the examination of a foetus of three months and 
a half, under the skin of whose neck an abscess 
was found .^f 
I have very often seen small superficial ab¬ 
scesses or pustules existing at birth, especially 
about the neck, face, and head. 
Dropsical effusions.—Several forms of serous 
effusion have been already mentioned as taking 
place during fatal life, and affecting either the 
cellular tissue, the great cavities of the abdo¬ 
men and thorax, those of the brain, or confined 
to particular organs and their appendages. 
Thus notice has been taken of the occurrence 
of generalanasarca, ascites, hydrothorax, hydrops 
pericardii, serous infiltration of the lung, hydro¬ 
cephalus, and hydro-rachitis or spina bifida. 
In one instance which I examined some years 
since there was general anasarca and serous 
effusion into every one of the cavities ; the mo¬ 
ther was healthy, but was in the habit of drink¬ 
ing enormous quantities of ardent spirits. 
The degree to which the head sometimes be¬ 
comes enlarged in utero by dropsy is as extraor¬ 
dinary as it is well known, and the difficulty of 
delivery thus produced is equally a matter of 
frequent observation with practitioners in mid¬ 
* Op. jam cit. p. 501. 
t Anat. Pathol, liv. xv. pi. xi. p. 2, obs. 4. 
j See Billard, Malad, des Enfans, p. 445. 
§ Liv. xv. pi. xi. p. 6, obs. 10. 
|| Anat. Pathol, by Townsend and West, vol. n. 
p. 703. 
Arch. Gén. de Méd. Mai 1834. 
wifery. In one specimen in my possession, the 
long diameter of the head is six inches, the trans¬ 
verse five and five-eighths,and the circumference 
nineteen inches : this case gave rise to the ne¬ 
cessity of performing cephalotomy. In another 
instance of twins I was called in, in conse¬ 
quence of delivery of the first child being found 
impracticable, the head being firmly retained 
after the expulsion of the rest of the body. I 
succeeded in extricating it, without perforation 
or instruments of any kind ; it measured eight¬ 
een inches and a half in circumference.*, In a 
case related by Perfect,f the head, when extri¬ 
cated from the pelvis, measured more than 
twenty-four inches in circumference. In an 
instance of an hydrocephalic twin, described by 
Dr. Patterson,! the circumference of the head 
was nearly twenty-one inches. 
Cases have also occurred in which enlarge¬ 
ment of the fatal belly from ascites has been 
sufficient to impede delivery ; no such case has 
come under the writer’s observation, but others 
have met with them.§ In another section of 
this article a case is noticed, in which immense 
distension of the fatal bladder produced great 
difficulty in effecting the delivery. See p.335. 
In such cases hydrocele has been sometimes 
observed at birth, and in other instances also.|| 
Ollivier (d’Angers) has described a case of 
dropsy confined to the cavity of the great epi¬ 
ploon in a well-formed child dead-born at the 
eighth month : the laminae of the peritoneum 
were separated by a serous fluid of a yellow 
colour, and perfectly limpid, in which were 
floating flakes of albumen : the posterior layer 
of the epiploon was slightly opaque. The 
tumour distended the abdomen enormously, 
and there was fluctuation as in ascites : there 
were present all the characters of circumscribed 
inflammation of the epiploon.^ 
Induration of the cellular tissue.—This pe¬ 
culiar affection, in the great majority of 
instances, does not invade the system for some 
days after birth, and even then it is of rare 
occurrence. My experience has not afforded 
me an opportunity of examining more than 
two cases, which were not congenital. 
It has been already described in this work 
(see Cellular Tissue, p. 516), and it ap¬ 
pears only necessary to add here that the 
affection is sometimes found fully established 
at birth. “ Many children,” says Andral,** 
“ come into the world with this affection,” and 
we have the testimony of Billardff and others 
to the same effect. Jaundice has been more 
frequently found than any other affection in 
* An accurate cast of it is preserved in the wri¬ 
ter’s museum. 
f Cases in Midwifery, vol. ii. p. 525. 
j Lond. Med. and Surg. Journ. Sept. 17, 1836, 
p. 86. 
§ See Gardien, Traité complet d’Accouchemens, 
tom. iii. p. 106 ; Dugès, Diet, de Méd. et de Chir. 
Pratique, tom. viii. p. 303. 
Il Graëtzer, Die Krankheiten des Fœtus, p. 159 ; 
Billard, Malad, des Enfans, p. 630. 
Archives Générales de Méd. Mai 1834. 
** Anat. Pathol, by Townsend and West, vol. ii. 
p. 580. 
ff Malad, des Enfans, p. 178.
        

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