482 PEOr. B. C. A. WINDLE ON" TESATOLOGICAL EVIDENCE 



atrophy is coafined to one side. We must, however, confess 

 that we have no direct observations on the nerve-centres in 

 support of these views. They are derived solely from cliuical 

 observations of cases, and the results may very well be put 

 down as due to mechanical causes, and belong to tlie same 

 category of cases as intra-uterine amputation &c." In con- 

 clusion, they say : — " We think that of all the explanations of club- 

 foot hitherto offered, a mechanical one is the most reliable and 

 satisfactory for the great majority of cases." Their remarks on 

 heredity in connection with this malformation are also worth 

 quoting. " With regard to heredity, the whole question is so 

 obscure that it is hardly profitable. Although cases of hereditary 

 transmission of the deformity from parents to children do 

 undoubtedly occur, yet in the vast majority of instances no such 

 hereditary influences can be traced, and this is even true ia 

 instances where several children in the same family have suf- 

 fered. The influence of heredity, however, may be invoked with 

 equal force, whatever view of the pathology of the disease be 

 adopted. But at first sight it may seem not a little remarkable, 

 that in some cases the deformity is transmitted along the 

 paternal line ; and it may be difficult to harmonise this fact 

 with the influence of environment on which we have insisted. 

 It need only be remarked, however, that the environment of 

 the foetus depends upon the foetus itself, not less than upon the 

 mother. Eor most recent observations show that the liquor 

 amnii may be considered throughout a foetal and not a maternal 

 product. Excess or deficiency in its amount may, therefore, be 

 the result of a tendency inherited either from the father or the 

 mother." It is evident that no definite opinion can at present 

 be hazarded as to the cause of talipes and, therefore, as to its 

 nature, whether blastogenic or somatogenic. 



Deficiencies due to Amniotic Adhesions. — These have already 

 been discussed sufficiently in earlier sections. 



Having now passed in review all the congenital malformations 

 with which I am acquainted, it remains for me to consider in the 

 succeeding sections certain general questions which appear to 

 need a separate treatment. These include, inter alia, the effects 

 of maternal impressions and of the maternal nutrition upon the 

 development of the embryo ; and the part, if any, played by the 

 nervous system in the production of abnormalities during the 

 same period. 



