FfETfS. 



320 



Fig. 159. 



Albert F. Veiel quotes a case from Froriep's 

 Notizen, bd.xii. p. 26, of a fetus " whose left 

 J'mil was separated, during pregnancy, from 

 the bone, and the fore foot was born by itself, 

 quite, healed."* 



The following case was recently published in 

 the American Journal of Medical Science, by 

 Dr. F. P. Fitch of New Boston. On the 17th 

 March a healthy woman, then in the seventh 

 month of pregnancy, suddenly discharged the 

 liquor amnii. On the 21st a substance escaped 

 from the vagina, which proved to be a perfectly 

 well-formed fatal foot, apparently separated at 

 the ankle-joint, and in a complete state of pre- 

 servation. On the 5th April she was delivered 

 of a seven-months' child, which lived about 

 half an hour. At the left side of the centre of 

 the forehead there was a horny protuberance of 

 the size of the middle finger; the face, also, 

 was greatly deformed. Upon the foot, the 

 place of separation was contracted to the size 

 of a small pin's head, and the heating process 

 luul apparently been as perfect, and progressed 

 nn/ n, iirhi us far as that on the lower extre- 

 mity of tin: innb.\ 



Within the last few months a child of a 

 month old was brought to me from the county 

 of Westmeath, in consequence of its having 

 been born deprived of the left hand. On exa- 

 mination I found the forearm of that side pre- 

 senting, a little above the wrist, the appearance 

 of a perfectly well-formed stump, as it would 

 be found after amputation by the surgeon's 

 knife; with this difference, however, that the 

 mark of cicatrix did not extend across the 

 stump, but was confined to a small circular 



* " Der linkc Fuss wiihrcnd dcr Schwangerschaft 

 sich von dcm Heine ablostc, iind der Vordcrfuss 

 fur sich, bcrcits geheilt, gcborcn wur<U>." 



t American Journal of tlin Medical Sciences, 

 No. xxxv. for May 1836, p. 90. 



depression in its centre; the child was other- 

 wise quite perfect and healthy. Unfortunately 

 I could not obtain any information as to whe- 

 ther the hand had been found at the time of 

 delivery or not, the poor woman having been 

 attended only by an ignorant country midwife. 

 Three cases, very similar to the above, are de- 

 scribed by Dr. Simpson.* 



I feel almost convinced that the removal of 

 limbs in this way is by no means so uncommon 

 an occurrence as the paucity of cases hitherto 

 recorded would, at first sight, lead us to con- 

 clude ; but the reason appears to me to be this, 

 when the separated portion of limb was not 

 accidentally discovered, Ihe imperfection seems 

 to have been considered quite as a matter of 

 course, and without further examination, as 

 arising from imperfect development or monstro- 

 sity, and, consequently, no search was made 

 for the deficient part ; and, even if search was 

 made, the amputated member might have been 

 so small as to escape undiscovered, involved in 

 the membranes, or buried in coagula ; even 

 though the child to which it belonged had at- 

 tained considerable size, because its separation 

 may, as we have seen, take place a consider- 

 able time previous to birth ; this is noticed in 

 Mr. VVatkinson's case, and is still more stri- 

 kingly exemplified in that described by Zagors- 

 ky, see Jig. 159. 



With regard to the theories which have been 

 advanced to account for such accidents as that 

 which we have been considering, some, regard- 

 ing them as the effects of mental emotions in 

 the mother, or of accidents encountered by 

 her, have attempted to support their views by 

 details which Ilaller truly designates as " adeo 

 fabulosa ut (idem auferant;" those who attri- 

 buted this phenomenon to gangrene did so 

 from theory, and have received no support for 

 their opinions even from the (acts which they 

 have themselves recorded; for it is expressly 

 mentioned that the parts which were the seat 

 of the injury seemed otherwise healthy, were 

 not discoloured, and at the point of division 

 were either partially or entirely healed over. 

 The explanation which facts fortunately enabled 

 me to offer does not depend on conjectural 

 reasoning or theoretical speculation for its 

 support, but its proof may be " oculis subjects 

 fidelibus" by the mere inspection of the parts, 

 which are preserved in my museum ; and with 

 regard to the nature of the process by which 

 the solution of continuity is effected, and the 

 foot, or other part amputated, it appeals to be 

 strictly that of disjunctive atrophy, and in a 

 great degree similar to that by which the sepa- 

 ration of the funisfrom the umbilicus is accom- 

 plished. 



Convulsive affections. Having alluded to 

 convulsive movements of the child in another 

 place as the occasional cause of certain phy- 

 sical injuries to it, such as fractures and dislo- 

 cations, a few words on the subject will hardly 

 be misplaced here, although the affection list-it' 

 may perhaps not come exactly within the scope 

 of this article. The variety in the activity of 



* Dublin Medical Journal, vol. x. p. 226. 



