FCETUS. 



333 



conjunction with this oedema of the cellular 

 tissue. Of seventy-seven cases examined by 

 Billard, thirty were affected with jaundice.* 



For a very full account of this subject see 

 Graetzer, die Krankheiten des Foetus : section 

 tderoderma. 



Cutaneous affections. Lesions of the skin 

 are probably the most numerous class of affec- 

 tions to which the foetus in utero is liable. 



Some of these appear to be in a great mea- 

 sure mechanically produced in consequence 

 of the occurrence of other diseases, as in cases 

 of spina bifida, encephalocele, and other tu- 

 mours of the head. In these instances the 

 skin covering the tumour is first attenuated 

 as it is distended, and subsequently it disap- 

 pears altogether, and not unfrequently becomes 

 ulcerated. In some instances the injury 

 observed on the skin is the result of inflamma- 

 tion either attacking the skin itself or the mem- 

 branes of the ovum; in the former case abscesses 

 may form and ulceration be produced. I have 

 frequently seen instances of both, and also 

 very distinct cicatrices, which must have been 

 a considerable time in existence. Ollivier 

 (d'Angers) describes a remarkable case of ulce- 

 ration on the legs of a child bora with clubbed 

 feet.f I have more than one instance in my 

 museum of destruction of the skin from adhe- 

 sion having taken place between the foetus and 

 the membranes. Excrescences from the skin 

 have been observed by the last-named author, 

 Billard,| and others. The writer once attended 

 a lady who gave birth to a very fine healthy 

 child with two excrescences attached by pe- 

 dicles over the third phalanx of each little 

 finger. Naevi of different kinds existing at 

 birth are matters of common observation, and 

 in not a few instances petechiac have been 

 observed in the form usually denominated pur- 

 pura haemorrhagica. 



Very many instances of the eruptive diseases 

 have been noticed in the immature foetus and 

 child at birth. Vogel and Rosen mention in- 

 stances of chilbren born with the traces of 

 measles, and Guersent says|| he saw an infant 

 born with the eruption on it, having taken the 

 disease from the mother. 



In the course of the last year I attended a 

 patient who was delivered a month before her 

 time, when just recovering from an attack of 

 scarlatina ; the child's skin exhibited the erup- 

 tion in several places : it recovered. 



* Ibid, p. 179. See also Deutschberg, Dissert, 

 de tumor, nonnul. congenitis,Vratislav, 1822, p. 21 j 

 and Abbild. t. ii. Leger, Considerations sur Tin- 

 durcissement du tissu cellulaire chez les nouveaux- 

 nes. Denis, Theses de Paris, n. 159, annee 1824, 

 de Tindurcissement du tissu cellulaire, &c. and 

 Recherches d'Anat. et de Physiol. Pathol. sur plu- 

 sieurs Maladies des Enfans nouveaux-nes, Paris, 

 1826, p. 145. Orfila, Le 5 ons de Med. Leg. p. 375. 

 Alibert, Nosol. Naturelle, p. 495-499. 



t Arch. Gen. de Med. Mai 1834. 



; Maladies des Enfans, p. 79. 



See Billard, op. jam cit. p. 92, 3. Graetzer, 

 p. 60. Cruveilhier, liv. xv. pi. ii. p. 2, 3, obs. 

 4 and 5. 



|| Diet, de Med. t. xviii. p. 513. For several 

 other references see Graetzer, die Krankheiten 

 des Foetus, p. 49. 



Small-pox has been observed on the child at 

 birth and under remarkable circumstances, as 

 in cases where the mother had not been affected 

 with the disease during gestation. See cases 

 by Jenner, Med. Chir. Trans, vol. i. p. 269 ; 

 and a very remarkable one by Mead, in which 

 " a certain woman who had formerly had the 

 small-pox, and was now near her reckoning, 

 attended her husband in the distemper. She 

 went her full time and was delivered of a dead 

 child. It may be needless to observe that she 

 did not catch it on this occasion, but the dead 

 body of the infant was a horrid sight, being 

 all over covered with the pustules ; a manifest 

 sign that it died of the disease before it was 

 brought into the world." Works, edit. 1767, 

 p. 253. 



Billard* mentions having seen in theMuseum 

 of Guy's Hospital a foetus of six months covered 

 with pustules of small-pox, which was born 

 when the mother was just recovering from the 

 disease. 



" Mary Gatton had confluent small-pox in 

 the seventh month of her pregnancy ; eighteen 

 days from the first attack of the eruptive fever 

 she was taken in labour and delivered of a 

 child, which seemed to have been dead five or 

 six days. Its body was covered with confluent 

 small-pox. The pustules were white and full 

 of matter, and from their size seemed to have 

 nearly attained their maturity /'f 



" A lady was inoculated in the seventh 

 month of her pregnancy, and on the ninth day 

 from the accession of the eruption, which was 

 moderate, she received a fall ; from that period 

 the motions of the child were no longer per- 

 ceptible : in eight days after she was taken in 

 labour, and delivered of a dead child covered 

 with a great quantity of variolous pustules, 

 which were prominent and in a state of suppu- 

 ration."]; 



Pemphigus has been observed on the child 

 at birth by Lobstein, Joerg,|| and others. 



When the system of either parent retains a 

 taint of syphilis, the child very frequently exhi- 

 bits at the time of birth unequivocal evidence 

 of being contaminated by the disease, and 

 sometimes of having already fallen a victim to 

 its ravages; though in the majority of such 

 cases the children are born alive, often appa- 

 rently healthy, and do not exhibit any appear- 

 ance of disease for a few weeks. 



In many instances children so tainted are 

 born in a state of complete putridity, and with 

 the skin either already stripped off or quite 

 loose and detached ; in other instances, which 

 are much more rare, the children have been 

 born alive, with a well-marked syphilitic erup- 



* Op. jam cit. p. 97. See also Graetzer, op. 

 cit p. 27. 



t Paper by Dr. Bland in Simmons' Lond. Med. 

 Journ. vol. ii. p. 204. 



$ Mem. Lond. Med. Soc. vol. iv. p. 364. 



$ Journ Complem. du Diet, des Sci. Med. t. vi. 

 p. 1. 



|| Handbuch der Kinderkrank. 1826, p. 310. 

 See also Siebold, Journal fur Geburtshiilte, &c. iv. 

 Bd. 1, St. 1823, s. 17. Meissner, Kinderkrank- 

 heiten 1. p. 406, 410. Wichmann, Beitrag zur 

 Kenntniss von Pemphigus, p. 15. 



