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Acephalous FœtusAuthor(s): John AllisonSource: Provincial Medical Journal and Retrospect of the Medical Sciences, Vol. 5, No. 116(Dec. 17, 1842), pp. 225-226Published by: BMJStable URL: http://www.jstor.org/stable/25491688 .

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MALFORMATIONS OF THE FCETUS. 225

worthy our recollection. To return to Fanny Barr; she was anxious to resume her domestic duties, pro

bably through fear of losing her employment, and

she had nearly persuaded me to give my permission

for her departure. But, on trying to leave, she said she

could not straighten herright arm. She had not com plained of this arm, but I found that the 'elbow was

flexed, and that neither could she extend it herself

nor suffer me to do so. I got Mr. Arnott to see it,

and he found unequivocal indications of inflammation

of the joint, with effusion into its cavity, and thicken ing of the tissues thereabout. This is a result not at

all uncommon-that is, scrofiilous inflammation of

the glands, or joinits, after all those blood diseases

proceeding, as it were, from the dregs of the disease.

I said in the commencement that those cases did not

furnish any uncommon features, but they may not

have proved useless in affording to ius these few prac

tical remarks. To one other case we may devote a passing notice.

The boy, Henry Field, aged thirteen, presents a case of chorea, it itself affording to uis nothing very

remarkable. The boy has lost the power of con

trolling the motions of his whole right side; the arms

and legs on that side, and even the head, are subject

to almost constant motion; his speech, too, is very

considerably affected. This has been of seven or eight years' duration. His mother and himself state

that he had headache, and that he was cupped and

leeched for it. His mother states that there is no

jactitation while ho sleeps. I believe that is the ordinary rule, and the cause is, that the influence of

the sensorium is at rest during sleep. Chorca is a

strange disease, but generally it is not a perilous one.

It is in most instances a disease of youth, and among

youth belongs to girls more than to boys, among

boys to those of the weaker and almost effeminate

constitution, and to children of dark hair and com

plexion more than to those of fair hair and com

plexion. It appears to be some disordered function of

the spinal chord over which the control of the will is

not perfect, but against that control the involuntary movements show a rebellion. It would seem that

when the will is put forth, the chord is partly con

trolled, but in part acts independently, and those ex

traordinary vibrationls and jactitations are thus pro

duced. In most cases there is no organic disease of

the chord; the instrument is not broken anywhere,

but is sadly out of tune; and, if we may follow up

the metaphor, we often effect a cure by bracing it up

again. Chorea may be said to originate in causes

where the mind is involved; it arises frequently from

sudden excitement, fright, serious alarm. Hence we

deduce the propriety of giving those medicines that

impart a healthy and firm tone to the mind-such as

steel. Purgatives are also useful where there is some

thing wrong in the digestive organs, and the sentient

extremities of the nerves connected with those organs

are thus affected. Where the chorea is accompanied

by headache, depletion is necessary by cupping and

leeches. The shower-bath is in many cases most

useful. Arsenic is a mineral tonic wwhich may be very

effectually used. In a most severe case of chorea in

another boy I ordered ten grains of the sulphate of

zinc, and the boy recovered.

There are some other cases, my remarks on which

I shall defer until next Saturday. One of them is a

case of severe headache. There are two or three

cases of that very curious affection, hysteria, and ano

ther which turns out to be a case of mere diuresis,

which is certainly not a very common malady in this

hospital. I had hoped to have some interesting remarks to

communicate on the use of iodide of potassium, but

those temarks must be reserved for another day.

ACEPHALOUS FETUS.

TO THE EDITORS OF THE PROVINCIAL MEDICAL

JOURNAL.

GENTLEMEN,-Last week the Provincial Medical Journal contained an interesting account of an acepha

lous fcetus, and although you did not seem to coin

cide in the remarks of maternal impressions affecting

the child in utero, yet with that impartiality which

oughIt to characterise public journalists, you hesitate

not to give insertioil to Mr. West's communication.

Should you deem the following case, which came

under my observation, possessed of any interest to the

profession, you will, perhaps, be kind enough to give

it a place in your columns.

In April last I was called on to attend Mrs.

in lier third confinement. She is in'disposition re

markably cheerful, possessed of a vivid imagination, and in company gives expression to a rapid flow of

ideas. On my arrival her pains were not very severe,

but the os uteri was sufficiently dilated to permit an

imperfect examination. Within the uterus my finger came ini contact with a soft irregularly fissured mass,

which I could not conceive to belong to any part

of the ovum withethe exception of the placenta. That

it was not that organ which presented, I felt pretty

confident from the complete absence of hamorrhage; but what it was else I could not decide until the os

uteri became more dilated. Determined to wait patiently, and ascertain what the presentation really

was as soon as that was practicable, I came down

stairs and found the husband of my patient in a state

of gxeat anxiety. Immediately I enitered the room

he hastily asked me if all was right. Associating his

hurried manner with my failure to obtain information

of his wife's actual state, I inquired of him why

he put such a question. In reply, he said that

during the whole time of his wife's pregnancy she had

en4tejined a most unaccountable dread lest her child

should be like that Qf Mrs. L., who lived in the same

street, and had given birthi about five years ago to a

living child, of which the head was exceedingly de

formed, and the relative position of its organs much

altered. When I saw this child, which is still alive

and quite idiotic, it presented a very repulsive appear

ance-its eyes were ted and vascular, and preterna

turally large and prominent, and situated on the upper

aspect of the head; the brain was malformed and in a

state of extreme atrophy, and the developihent of the

facial parts excessive' This child had been seen by

my patient about the commencement of her preg

nancy, and had made such an impression on her mind

as to alarm both herself aild her husbatid lest their

future offspring should be similarly deformed. Her

husband told me thAt he had often wished to mention

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226 TOBACCO INJECTIONS IN ENTERITIS.

the circumstance to me, but supposed I would treat it with ridicule. The pains now became regular and increased in severity, and on making a second exa

mination, I found the os uteri sufficiently dilated to enable me to satisfy myself respecting the position of the child; still the same soft substance as at first met

my touch; on passing my finger on, however, I could distinguish the features-the eyes, the nose, the mouth -and lastly, on carrying my finger round, my informa tion was completed by feeling an ear. My mind was Inow relieved and satisfied; I had no doubt the child

was monstrous; the labor was tedious, and the uterine efforts were very violent before the child was expelled.

Although I was careful not to use any expression from which either the mother or nurse could infer that any thing unusual had occurred, still no sooner was the child born than the mother expressed a wish not to see it; she knew, she said, how it looked. The child,

which showed no signs of life, was, without excep tion, the largest I had ever seen; its breadth of shoulders and plumpness caused it to resemble one a

month old; yet, though the trunk and extremities were faultless, the head presented such a degree of deformity as to have but little to identify it with the human form. The eyes were large, vascular, and prominent, and the orbits were bounded superiorly by the soft, bloody, and irregularly fissured tumor which I detected in my first examination. This mass was un covered at any part by bone, and on making several incisions, it was found to contain nothing but blood,

without even a trace of nervous matter, so completely did it occupythe place of the cerebrum and cerebellum.

To an ordinary observer this child, and especially its full, large, red eyes, bore a strong resemblance to the one which made such an impression on my pa tient's mind. Many such acephalous fcetus have been described, and every anatomical museum contains specimens of the kind; this case, therefore, can be of interest only in so far as it illustrates a doctrine heid and supported by some of our best physiologists, and believed by the great mass of the community, as well in ancient as in modern times. That there is no di rect nervous communication between the mother and child, may or may not be true; facts, they say, are stubborn things, and cannot be easily gainsaid. Per sons engaged in the breeding of our domesticated ani

mals recognise the fact, that impressions made on the nervous system of the mother do influence the cha racter of the offspring; and without any ilngenious theory, they, nevertheless, find it to be profitable in practice. Valuable though the case of Mr. West nay be, this one I conceive to be still more so, in confirmation of the theory he would support. In his case the mother accounted for the phenomenon after she was aware of its existence; in the one which I have related, the character of the offspring was all but predicted by the parents; and when we remem ber how acute females are in their way of accounting for events, equal to, or above their comprehension, your editorial remark on Mr. West's case appears quite justifiable.

An instance of a similar kind was mentioned to me

lately by a highly intelligent surgeon in this neigh bourhood. He was called on to attend a woman of her first child, and immediately on delivery, before any of the attendants could see the child, the mother

anxiously inquired if it was all right. Her medical

attendant asked her, why should it be otherwise? and

in reply she stated, that eight months ago a person

threw a mouse at her, which struck her on the upper

lip, and that from that time till herconfinement the cir

cumstance had dwelt almost incessantly on her mind,

and begot a firm belief that the child would be in

some way marked. On bringing the child to the light,

the mother's suspicions were found to be strictly veri fied, for, sure enough, on its upper lip there was a deep

brown mark, presenting a very correct profile of the

little animal which the mother so much dreaded. Its

head, its body, its limbs, and tail, were all displayed

with a fidelity surpassed only by the process of the

immortal Daguerre. The lip of many of your readers

may curl with the smile of incredulity; nevertheless, these cases are strictly true. The girl, whose case

was related to me by the surgeon who attended her

mother in her confinement, is, for anything I know to

the contrary, still alive-a living evidence of tho fact.

I am, Gentlemen,

Your obedient servant, JOHN ALLISON.

Bridlington, Dec. 7, 1842.

ON TOBACCO INJECTIONS IN CASES OF ENTERITIS.

TO THE EDITORS OF THE PROVINCIAL MEDICAL JOURNAL.

GENTLEMEN,-The history of the two following cases, which I forward to you for insertion in the Provincial Medical Journal, illustrates the efficacy of tobacco injections in some severe forms of abdominal disease.

I am, Gentlemen, Your obedient servant,

JOHN WATERS, M.D., M.R.C.S. (E.) 62, Torrington-square,

Dec. 4, 1842.

CASE I.-A lady, aged forty, of robust constitution, had been complaining of general derangement in her health for about a week, but not sufficient to prevent her attending to her domestic concerns, when she was suddenly seized with pain in the abdomen, -but

particularly in the course of the sigmoid flexure of the colon, and spine, and which she ascribed to the

effects of cold. The pain increasing in severity, I was requested to see her. At my first visit, I found her sitting up in bed, the body flexed as much as possible anteriorly; she vomited incessantly, but only threw up a small quantity of viscid mucus. On press ing the abdomen she complained of pain, particularly in the left side; the heat of surface was natural, and

there was no distension or retraction of the abdomen; some borborygmus; pulse 110, small, wiry; tongue slightly red, loaded at the base; no thirst or cepha lalgia; the bowels had not been acted on during the

last two days. I ordered her to be bled to syncope, and to take immediately five grains of calomel with

one of opium. This treatment arrested the vomiting, but the dull, aching pain and borborygmus seemed not in the least relieved. The patient continued in

this state without any appearance of improvement

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