504 PEDIATRICS 



served by Benjamin Rush. In many instances still-births, early 

 diseases, atrophy, and undue mortality of the young depend on 

 ante-natal happenings. The condition and diet of the mother in- 

 fluences her offspring. The danger of a contracted pelvis, and the 

 necessity of premature delivery may be obviated by the restric- 

 tion of the diet, or even by appropriate (thyroid and other) medi- 

 cation of the pregnant woman. Experience and experiment tell 

 the same story. The continued practice of preventing conception 

 causes endometritis. Alcoholism causes chronic placentitis, pre- 

 mature confinement, or still-birth. So does chronic phosphorus 

 and lead poisoning. Fortunately, however, the usual medication 

 resorted to during labor is rarely dangerous, for even morphine 

 or ergot doses given to the parturient woman on proper indica- 

 tions affect the newly-born rarely, and chloroform anesthesia almost 

 never. 



Scanty amniotic liquor, by the prevention of free intra-uterine 

 excursions, may cause club-foot; or close contact of the surfaces 

 of the embryo and the membranes give rise to adhesions of the 

 placenta and the head, to filaments and bands whose pressure or 

 traction produces grooving or amputation of limbs, cohesion of 

 toes or ringers, umbilical, meningeal, encephalic, or spinal hernia; 

 not in extra-uterine pregnancy only, where such occurrences are 

 very frequent. Even the majority of harelips and fissured palates 

 have that origin. Arrests of development and fetal inflammation 

 are the headings under which most of the anomalies of the newly- 

 born may be subsumed; congenital diseases of the ear and of the 

 heart may result from either cause or from both. Obstructions 

 of the intestines, the rare closures of the esophagus, the ureter, 

 and the urethra, with hydro-nephrosis and cystic degeneration of 

 the kidneys, are probably more due to excessive cell proliferation 

 in the minute original grooves than to inflammation. 



The insufficient closure of normal embryonic fissures or grooves 

 explains many cases of spina bifida, many of encephalocele, most 

 of the split lips and palates, all of porencephalus, bifid uvula and 

 epiglottis, pharyngeal and thyroglossal fistulse, the communica- 

 tions between the intestinal and uro-genital tracts, and the per- 

 sistency and patency of the urachus. 1 



Heredity need not show itself in the production of a fully de- 

 veloped disease. It exhibits itself normally either in equality or 

 resemblances, either total or partial, of the body, or some one or 



1 J. W. Ballantyne, in his manual of ante-natal pathology and hygiene, 1902, 

 has a separate chapter on the relations of ante-natal pathology to other branches of 

 study, to general pathology, to the biological sciences, such as anatomy, embryo- 

 logy, physiology, botany, and zoology, and to the medical, including obstetrics, 

 public health, pediatrics, medicine, psychology, dermatology, surgery, ortho- 

 pedics and medical jurisprudence, finally to gynecology and neo-natal pathology. 



