336 PHILOSOPHICAL TRANSACTIONS. £aNNO 1798. 



The inference which has been drawn seems further confirmed, from the colour 

 and heat of this child, during life, being not perceptibly different from those of 

 other children. In all those cases of malformation of the heart where the foramen 

 ovale, or the ductus arteriosus, has continued open; or where the septum of the 

 ventricles has been perforated, and the pulmonary artery small, and at the same 

 time 2 ventricles, it has been observed, that the body had a livid colour, and in 

 general that there was a deficiency of heat. From the particular inquiries which I 

 made, concerning the heat and colour of this child, of the professional gentlemen 

 who saw it during life, and of the nurse who attended and dressed it, I found that 

 the heat, so far as could be judged by the feeling, for it was not tried by the ther- 

 mometer, was in no respect different from that of other children ; and that the co- 

 lour of the skin was perfectly natural, except that, on the day on which it was 

 born, and a short period before its death, the lips occasionally had something of a 

 livid appearance; but that this did not last any time, as they were generally pale. 

 This occasional lividness would happen to a child in that state, should the heart and 

 circulation be in no way different from what they naturally are. 



I could meet with no other remarkable circumstances, either in the history of 

 the mother during pregnancy, or in the child after birth. It cried occasionally, like 

 other children, but seemed weak, and in pain; it slept; it sucked heartily, even a 

 few hours before its death, and had apparently healthy evacuations of urine and 

 faeces. Its death can be satisfactorily accounted for, from another cause than the 

 extraordinary formation of its heart and blood-vessels. The membranous covering 

 on the fore part of the abdomen, did not appear to possess sufficient vascularity to 

 retain its life after birth ; for it immediately lost its living principle, «nd became 

 putrid and mouldy in parts. Previous to the child's death, a process of separation 

 had begun, between it and the living parts to which it was connected, and a line 

 of inflammation was distinctly seen. Had this process been completed, and the 

 slough thrown off, the heart would have been exposed; but, before this, the heart 

 itself had inflamed; which was proved from its being found covered with a coat of 

 coagulable lymph recently thrown out, and from this inflammation its death must 

 have arisen. * 



Had the heart been covered with the usual parietes of the abdomen, it is pro- 

 bable, notwithstanding its situation, that this child might have lived in a tolerable 

 state of health for years; but must constantly have been exposed to have its heart 

 injured by some external accident, from its not being defended by the ribs and the 

 sternum. The formation and disposition of the heart and vessels, in this child, 



circumstances similar to the circulation in other children previous to that period. A child, before birth, 

 may be said to have a single heart j as both the auricles communicate together, by means of the foramen 

 ovale ; and the pulmonary artery communicates with the aorta, by means of the ductus arteriosus. 

 Hence, in the foetal heart, the blood returned from the body, which is of a dark colour, and the blood 

 returned from the placenta, which is florid, are poured into the same auricle; the blood which is sent to 

 the placenta is therefore already in part oxygenated. — Orig. 



