208 PATHOLOGY OF PREGNANCY. 



Hydrocephalus, ascitis, anasarca, and chlorosis, may also lead to the 

 death of the foetus, which in nearly every case is not only the most 

 frequent predisposing cause of abortion, but is almost a certain deter- 

 mining cause of its expulsion, Hydramnios, and other morbid condi- 

 tions of the foetal membranes, or faulty formation or relations between 

 the placentae, are other causes ; and congenital malformations of the 

 foetus, malposition, or exaggerated volume are also mentioned. The 

 presence of several foetuses often leads to abortion in uniparous animals. 



Disease of the uterus will, of course, be very likely to lead to the pre- 

 mature expulsion of the ovum or foetus. Metritis, abnormal conditions 

 of the mucous membrane, as well as new formations — such as fibroid 

 and carcinoma, and other alterations by which the enlargement of the 

 organ is hindered — as enormous tumours in the abdomen, ovarian 

 dropsy, etc. — will predispose to or excite abortion, as will also every 

 condition which leads to hyperaemia of this viscus. 



Abortion has not unfrequently been ascribed to some defects or other 

 influences in the male, though in what these consist has not been 

 explicitly stated ; unless they are to be found in the debility arising 

 from too frequent usage, or other causes related to the animal's state 

 of health. There is strong and abundant evidence that a male en- 

 feebled by too much use, is very likely to be a cause of abortion in the 

 females to which he is put. This accident has also been said to 

 occur frequently when the male was larger and more powerful than 

 the female. 



Various injuries to, and diseases of the foetus or its envelopes, may 

 lead to the same result. External violence may not only injure the 

 uterus itself, so as to produce abortion, but the foetus even may sustain 

 damage. Cauvet has remarked in a case of abortion in a Mare brought 

 about by kicks on the abdomen, that the foetal membranes exhibited 

 at the corresponding point an enormous ecchymosis, and behind 

 the shoulder of the foetus, which was in relation to this extravasation, 

 was a large brown-coloured exudation. Another observer has witnessed 

 an adhesion between the skin on the cranium of a foetus and the foetal 

 membranes, as well as depression of the cranial bones — all evidently 

 due to external violence. 



The foetus may be poisoned by food or medicines which do not pro- 

 duce any appreciable effect on the parent. 



fcEtal circulation is disturbed. Premature pains may be caused by (1) increased body 

 temperature ; (2) altered blood ; (3) changes in the uterine mucous membrane, as in 

 endometritis exanthematica ; or (4) toxins present in the blood. If the deficiency in 

 oxygen occurs rapidly, the foetus dies ; if more gradually, pains are induced. In typhoid 

 fever abortion occurs in more than half the cases, and the foetus is generally born dead, 

 the death being most often due to the transmitted infection. Cholera is not trans- 

 mitted to the fix'tus, the death beinij here dvie to the altered blood, to an endometriti.=, 

 to a diseased fcetal })lacenta, and to temperature variations. In measles the fretus rarely 

 dies. In severe malaria ihe ftjetus is more often born alive, but soon dies of malarial 

 cachexia. In pneumonia the death of the foetus is not uncommon, and is due to 

 asphyxia. Variola frequently kills the fcetus, yet many are born alive. As regards the 

 pains, the fcetus may be expelled in variola even during the suppurative stage ; in 

 malaria after the paroxysm ; in erysipelas most often when the eruption appears ; in 

 cholera during the transition stage ; in influenza soon after the onset of the febrile 

 symptoms, and in pneumonia on the third or fourth day. In typhoid fever the abortion 

 may be accompanied by much hiemorrhage, or strong contractions and little hismorrhage. 

 In cholera the htemorrhage is profuse, and the contractions violent. The foetus is mostly 

 much more threatened by the altered temperature, disturbed circulation, and patho- 

 logical changes in the endometrium, than by the transmission of the infection. — 

 Munchener Med. Wochenschrijt, December 26, 1894. 



