ACCIDENTS OF PREGNANCY. 201 



been born for two, four, or six months. But in other cases there can 

 scarcely be a doubt that the fci'tus perishes when the first inelTectual 

 expulsive efforts are made by the mother, or even at a period anterior 

 to the ordinary occurrence of parturition, as is proved by the absence 

 of hair, and the small size and weight of the creature ; while, again, it 

 may live for some hours after rupture of the membranes, provided it 

 can breathe, or the placental connections are intact. 



In all cases, as a rule, if the air does not obtain access to the uterine 

 cavity, putrefaction does not ensue ; and when the uterus is examined 

 after death, it is found to be closely contracted on its contents, its 

 raucous membrane healthy or slightly ecchymosed here and there, with 

 the cotyledons pale, wasted, and separated from the placentuliR. Some- 

 times between the inner surface of the uterus and the chorion there is 

 a gelatinous mass, which covers the ftt'tus and conceals the placental 

 cotyledons, these being decayed, spongy, and sometimes completely 

 destroyed. The liquor amnii has also been absorbed ; so that the 

 membranes ai-e in close contact with the foetus, and may even have 

 become adherent to it in places. The foetus itself is desiccated by 

 absorption, and its skin is hard and dry as if tanned, or it is wrinkled 

 and shrivelled ; while the flesh, if any remains, is either perfectly white, 

 or pale and faded-looking in colour, and emits a kind of rancid odour. 

 Other organs are pale and bloodless, and more or less undergoing fatty 

 degeneration. When the retention has continued for a long time, all 

 the soft textures may disappear, and nothing remain but the bones ; in 

 other instances the fcrtus and its membranes become the seat of calca- 

 reous infiltration, and constitute what has been termed a Uthop(edian. 



It is sometimes extraordinary how perfectly a fcotus is protected from 

 decay in the uterus. For instance, in the Veterinary Journal (July, 

 1876), Mr. Taylor mentions one which had been retained for seven 

 months beyond the normal period ; and yet with the exception of 

 absorption of the eyes, it did not present indications of having passed 

 more than a few days in excess of the usual term in the uterus. 



When the envelopes have been ruptured, however, and the liquor 

 amnii has escaped, we have a different pathological condition. Then, 

 through the partially dilated os the air has been admitted, and if imme- 

 diately before this the fcctus was alive, it may then die and rapidly 

 submit to the putrefactive process, its soft parts decomposing and 

 macerating, and forming a most foul-smelling mass ; so that when the 

 uterus is opened, we discover a gi-ey or greyish-red fluid emitting a 

 most disgusting odour, and containing portions of matter resembling 

 adipocere, and perhaps bones which may yet be covered by soft parts 

 and held together by ligaments, or entirely disunited and decaying. 

 The uterus itself shows evidence, in the majority of cases, of chronic 

 metritis ; sometimes abscesses have been formed in its texture, or it has 

 become adherent to other organs — as the intestine, or such tissues as 

 the abdominal walls — with which it has established fistulous communi- 

 cations, and through which portions or the whole of the fcctus may be 

 passed. 



In the case of twins, it sometimes happens that one of them dies, and 

 this occasions symptoms of abortion ; but delivery of the dead foetus 

 cannot be effected, owing to the obstruction offered by the living one, 

 which is born at the usual time, the parent being in good health. But 

 days, weeks, or even months after, the remains of the dead foetus may 

 be passed, or have to be extracted from the uterus. 



