318 



FCETUS. 



of many others ; and that very year cutting up 

 a large lemon, I found another, small, but yet 

 a perfect lemon in it, which had also a yellow 

 rind." 



Many other instances of anomalies resulting 

 from cohesion and intus-susception,* might be 

 referred to, but they will find their place with 

 more propriety under the article MONSTROSITY. 

 Mislocation of the germ during its growth 

 and development is well known to be produc- 

 tive of serious consequences, not only to the 

 foetus, but unfortunately involves great danger 

 to the mother also, as in those instances in 

 which it has been developed in the ovary,f the 

 Fallopian tube, the cavity of the abdomen, or 

 in the substance of the uterus constituting in- 

 terstitial pregnancy. I 



Atrophy. A very common occurrence to 

 the foetus in utero is atrophy, or a complete 

 arrest of growth from disease attacking its en- 

 velopes, especially the placenta or cord; in 

 which case, a deficient and unhealthy supply 

 of nutrition is furnished to the child, which 

 either perishes completely or has its develop- 

 ment retarded to such a degree, as not to pre- 

 sent dimensions or characters corresponding to 

 perhaps half the period that has really elapsed 

 since conception ; as happened in the follow- 

 ing case : a lady who menstruated in the last 

 week of July, began about the middle of 

 August to exhibit unequivocal symptoms of 

 pregnancy, which proceeded regularly till the 

 middle of October, when indications of threat- 

 ened abortion appeared, with pain, and the re- 

 peated expulsion of large coagula and sub- 

 stances of various appearances. After this, the 

 previously existing symptoms of pregnancy en- 

 tirely disappeared, and it was supposed that 

 miscarriage had occurred and that the ovum 

 had escaped, unnoticed, amidst the masses of 

 coagula. The lady resumed her ordinary habits 

 and went into society as usual, without expe- 

 riencing any uneasiness or unhealthy symptom, 

 except irregular uterine discharges, which were 

 supposed to be menstrual : so matters proceed- 

 ed until the 7th January, when, after a long 

 drive, she was seized with periodical pains ac- 

 companied by smart uterine haemorrhage, in 

 consequence of which I was sent for. 1 found 

 the os uteri open and an ovum partly protruded 

 through it, this I succeeded in disengaging and 

 bringing away; on examination it presented 

 the general appearances as to size, form, and 

 growth of the foetus, of an ovum of less than 

 two months, but the placenta was as large and 

 as much formed as it should be at three months, 

 and was moreover quite unhealthy, being 

 throughout affected with what is usually called 

 the tubercular state of that organ ; the foetus 

 seemed perfectly healthy, but very small ; and 

 the umbilical cord was only about half an inch 

 in length, much hypertrophied, being sud- 

 denly enlarged on leaving the placenta, to three 



* See Dublin Journal of Medical Science, vol. iv. 

 p. 294, and as before note t- 



t See Dub. Mcd. Joum. vol. ii. p. 195. 



J See a full account of this subject in Mcmoires 

 by Brcschet and Geoffrey St. Hilairc; Repertoire 

 Generate d'Anatomic, &c. No. 1. pp. 72, 7o, 91. 



or four times its natural diameter, and aiain as 

 suddenly contracted almost to a thread, where 

 it joined the abdomen of the foetus. See sub- 

 joined sketch, of the natural size. 



Fig. 147. 



Cruveilhier* relates the particulars of a case 

 in which the effect of disease of the placenta in 

 producing atrophy of the foetus was strikingly 

 shewn in twins at the sixth month, one of whom 

 possessed the full development and characters 

 belonging to that period, but the other, whose 

 portion of the joined placentae was thin and mi- 

 vascular, presented a size corresponding to not 

 more than three months, as shewn in Jig. 148. 



In another case, formerly under the writer's 

 care, the foetus expelled at the ninth month had 

 only grown during the first three-t 



Such cases as the above possess an interest 

 and a demand on our attention of a very im- 

 portant kind, as illustrative of the necessity for 

 carefully examining into the state of the foetal 

 appendages as to their healthy condition or 

 otherwise, before we venture to pronounce an 

 opinion on the time that has elapsed since con- 

 ception, merely from the size or general ap- 

 pearance of an ovum or foetus shewn to us ; 

 for here we have, in one instance, an ovum, the 

 size of which and that of the contained foetus, 

 would indicate a period of two months' preg- 

 nancy only, whereas Jive months had really 

 elapsed from the time of conception, for the 

 parties had not cohabited since the time of the 

 threatened abortion ; and in the other case an 

 ovum of three months' growth is expelled nine 

 months after conception. Now, in either case, 

 had the husband happened to die, or to have 



* Anatomic Pathologique, liv. vi. pi. vi ; see 

 also Gr'actzer, die Krankheiten des foetus, p. 83. 



t See my Exposition of the Signs of Pregnancy, 

 &c. pp. 96, 7, and also pp. 210, 11, and 259, 60, 

 of same work. 



