TERATOLOGY. 



919 



closed at a later period than usual. An ex- 

 ample of it is given in my Tabula XXIV. 

 fg. 4. Sometimes the muscles of the anterior 

 abdominal wall are wanting, in which case the 

 convolutions of the intestines may be seen and 

 felt through the skin (Von Ammoii). The 

 thoracic and abdominal cavities being open 

 in the first periods of embryogenesis, if this 

 condition persists abnormally, it produces 

 ectopia of the thoracic and abdominal viscera. 

 The aperture through which the ectopia takes 

 place has a constant tendency to close; it 

 shrinks therefore sometimes to a very small 

 opening (Hammer). Sometimes it is closed 

 in the middle, by a band which separates the 

 uncovered viscera into two portions (Hiihner, 

 Wolff). 



Its principal forms are : 



1. Fissure of the whole anterior Wall of the 

 Body. 



a. Complete ectopia of the thoracic and abdo- 

 minal viscera, which lie bare upon the anterior 

 surface of the body, to which is generally 

 added a cloaca. (Fig. 600.) 



% 



Fig. 600. 



Child with ectopid viscerum. 



a, liver ; b, heart ; c, c, lung ; d, stomach ; e, spleen ; 

 f,f, intestinal canal ; g, kidrtey ; h, chorion ; f, am- 

 nion ; k, umbilical cord ; m, placenta. 



The skeleton is very imperfect, in this com- 

 plete ectopia ; the thorax open, and the ver- 

 tebral column misformed by scoliosis. This 

 may produce, as often met with in calves, a 

 complete inversion of the body, so that 

 through distortion of the spine, the head is 



placed between the hind feet. This is what 

 Gurlt calls schistozomus reflexus, and what I 

 represent in Jig. 601. 



Fig. 601. 



Schistozomus reflexus (Gurlt). 



2. Fissure of the Thorax. 



Ectopia of the heart. In the regular evo- 

 lution of the foetus, the opening on the 

 anterior wall of the body closes itself, first at 

 its superior part, so as to cover the thoracic 

 viscera, while a part of the abdominal intes- 

 tines still remain out of their cavity and in 

 the sheath of the umbilical cord. Thus the 

 thoracic cavity is in general already closed, 

 whilst the abdominal is yet open. Neverthe- 

 less, it sometimes happens that the abdominal 

 cavity is completed, and that its viscera are 

 perfectly enclosed, whilst the thorax remains 

 open, and the heart is placed on its anterior 

 surface. In this malformation, called ectopia 

 cordis, the heart has no pericardium, and is 

 situated on the median line of the anterior 

 wall of the thorax ; it is more or less rounded, 

 and in general well formed, as may be seen in 

 fig. 595. The sternum is wanting (Tournelle, 

 Norand, Sandifort) ; divided into two parts 

 (Buttner, Martinez) ; or formed only by the 

 manubrium (Manchardt). It is rarely com- 

 plete ; but this is often the case when the 

 heart protrudes at the neck (Muse, Bubon- 

 nais, Breschet), or in the epigastric region 

 (Wilson). 



During foetal life, the ectopia of the heart 

 is immaterial, but soon after birth it causes 

 the death of the child. Cruveilhier published 

 some interesting observations on the move- 

 ments of the heart in a case in which life was 

 protracted for a longer time than usual.* 



* British and Foreign Review, No. XXVI. 

 October, 1841, p. 533, 



3 P 3 



