20 TKANSMISSION OF MICEOBIC DISEASES. 



often traceable to an hereditary cause, which favor or resist the 

 action of microbic causes. During the last few years great pro- 

 gress has been made in showing that hereditary disease, in many 

 instances, at least, is due to a more direct cause the transmission 

 from mother to foetus of the essential cause of the disease. This 

 method of infection is not only interesting from a scientific stand- 

 point, but is of the greatest practical importance, alike to the sur- 

 geon and physician, in regard to prophylaxis, diagnosis, and treat- 

 ment of many forms of disease. Although our knowledge of the 

 intra-uterine origin of microbic diseases is yet imperfect, there can 

 be no doubt that future study and research will clear up many 

 existing dark points, and furnish a satisfactory demonstrative ex- 

 planation of the direct and indirect hereditary influences in the 

 causation of disease. I shall in this connection refer particularly to 

 the clinical observations and experimental work which tend to prove 

 the direct transmission of pathogenic microbes from the mother to 

 the foetus. 



1. CLINICAL EVIDENCES. Lebedeff ("Ueber die intra-uterine 

 Uebertragbarkeit des Erysipels," Zeitschrift fur Gebwi&hMfe, B. 

 xii. ~No. 2) reports a case of premature birth which occurred eight 

 days after the mother had recovered from erysipelas. The child 

 died ten minutes after birth, and the author found Fehleisen's 

 streptococcus in the lymphatic vessels, in the diseased skin, and in 

 the umbilical cord, but not in the placenta. The author believes 

 that the streptococci were transported from the lymphatic vessels 

 of the lower extremities of the mother through the lymphatics of 

 the uterus into the placental vessels, and from the maternal into 

 the foetal circulation. 



Curt Jani (Lancet, September 4, 1886, p. 455) has examined the 

 healthy sexual organs of nine male phthisical patients for tubercle 

 bacilli. No bacilli were found, in any of these, in the semen from 

 the vesiculse seminales ; but, on the other hand, in five out of eight 

 cases a few were found in the testicle, and in four out of six in the 

 prostate. The testicles appeared healthy in structure. He further 

 examined two women who died of pulmonary phthisis, the ovaries 

 in both presenting negative results. In one case of chronic pul 

 monary phthisis, with extensive intestinal tuberculosis, he exam- 

 ined the Fallopian tubes and found tubercle bacilli. He believes 

 that the tuberculous virus can be transmitted from parents to 

 offspring in one of two ways : 1. Through the semen of the male. 

 2. Through the migration of bacilli into the uterus from the ab- 

 dominal cavity. Infection of the impregnated ovum by the 

 placental circulation he thinks must be unusual, because the exami- 

 nation of the body of a woman, five months pregnant, who died 

 from acute miliary tuberculosis, in whom infection took place 



