XII, B, 2 Mendoza-Guazon: Anatomicopathologic Lesions 53 



following an infected cephalohematoma, and another acute mem- 

 braneous enteritis, acute suppurative pancreatitis, acute choledo- 

 chitis, and acute hemorrhagic nephritis. The case of suppurative 

 meningitis had erosion of the skin covering a congenital sacral 

 spina bifida (sacral meningomyelocele). (6) 



Sixth day, 1 case. Hemorrhage in the lungs and acute gastro- 

 duodenitis. 



From this we can see that hemorrhage played a great part 

 in causing death during the first days of life, but we cannot . 

 take this as the rule in the city of Manila, for many of our 

 cases came from the obstetrical department of the Philippine 

 General Hospital, whose mothers asked help only when all the 

 outside resources were exhausted. 



Knopf elmacher (29) says that hemorrhage in the newborn oc- 

 curs frequently in unassisted as well as in assisted labors. The 

 hemorrhage is in part traumatic in origin, in part, however, due to 

 interruption in the placental circulation through compression 

 of the cord or through asphyxia. 



Holt (27) thinks that the predisposing cause of the frequence 

 of hemorrhage in young infants is due to the extreme delicacy 

 of the blood vessels and the great changes taking place in the 

 blood itself and in the circulation as a result of the passage from 

 intrauterine to extrauterine life. Without taking into considera- 

 tion those cases due to trauma and those due to infection, he 

 mentions a class in which the hemorrhages are not associated 

 with any other known process and in which the bleeding is 

 extensive, multiple in location, and spontaneous in origin, and 

 ceases also in the same way. 



Cautley(8) divides the hemorrhagic diseases of the newborn 

 into three : accidental, traumatic, and pyogenic. He states that 

 in true hemorrhagic disease there is a spontaneous capillary 

 oozing, which begins at a variable period after birth and proves 

 fatal or lasts for a few days to a few weeks and yet ends in 

 recovery. The circulatory disturbances due to ligature of the 

 cord at birth or compression of the cord during labor may cause 

 hyperaemia of the mucous membranes and hemorrhagic oozing 

 and extravasation throughout the body. Similar congestion can 

 be produced by backward pressure from congenital heart lesions, 

 the respiratory obstruction in asphyxia and atelectasis, and he- 

 patic cirrhosis. Gastrointestinal hemorrhage may thus be a 

 kind of epistaxis from the congested membrane in consequence 

 of its sudden functional activity, possibly associated with de- 

 ficient coagulability of the blood. 



