CLINICAL EVIDENCES. 21 



through the growth of a caseous mass in a pulmonary vein, showed 

 that there were no bacilli either in the placental attachment, in the 

 lungs, or in any of the organs usually the seat of localization in the 

 embryo. He, however, considers that it is by no means certain 

 that in chronic miliary tuberculosis deposits may not form in the 

 neighborhood of the placenta, and thus infect the foetal organism. 



That pathogenic microorganisms may exist in the blood of 

 apparently healthy mothers without doing any harm is well illus- 

 trated by children who have been born suffering from acute suppu- 

 rative osteomyelitis, while the mother, through whose blood only 

 the microorganisms could have come, showed no evidences of 

 disease. Roseubach reports such a case in his article on acute 

 osteomyelitis. 



Sangalli (Virchow u. Hirsch's JahresbericM, 1883, B. 1, p. 383) 

 found the bacilli of anthrax in the blood of a foetus from a woman 

 who had died of carbuncle. In opposition to the views of Golgi 

 and others, he affirms that the transmission of the disease from the 

 mother to the foetus in utero could only have taken place by the 

 passage of the bacilli or spores from the maternal to the foetal circu- 

 lation through the placenta. 



Ahlfeld and Marchand (Centralblatt f. Bakteriologie u. Para- 

 sitenkunde, No. 14, 1887) report the case of a woman who presented 

 no symptoms of disease except a moderate pallor and tympanitic 

 disteution of the abdomen. After a normal labor she gave birth to 

 her second child ; eight hours after delivery the patient died in 

 collapse, for which no explanation could be found. The autopsy 

 revealed anthrax as the cause of death. The child died four days 

 after birth from the same cause. The mother, as was later ascer- 

 tained, contracted the disease in sorting horsehair, and the child 

 was infected directly through the placental circulation. 



Netter (" Transmission de la pneumonic et de Pinfection pueu- 

 monique de la mere an foetus/' Compt. rend., March 9, 1889) 

 reports a carefully -observed case of the direct transmission of the 

 diplococcus of pneumonia from mother to foetus. The mother was 

 a Vl.-para, pregnant eight months when she was attacked with 

 croupous pneumonia, which terminated on the seventh day in 

 recovery. On the ninth day after the attack she was delivered of a 

 living child. The child died on the fifth day after birth. The 

 autopsy revealed lobar pneumonia, involving the right upper lobe, 

 double fibrinous pleuritis, pericarditis, suppurative meningitis, and 

 otitis media on both sides. Bacteriological examination of the dif- 

 ferent inflammatory products, as well as of the blood taken from the 

 left ventricle, showed the presence of Frankel's diplococcus of 

 pneumonia. 



