Effects of inflammation, 4•e.—The foetus in utero, even at early periods of its developement, is liable to a large number of organic altera tions, and even to lose its life, in consequence of inflammation attacking the uterus of the mother, the fatal appendages, or its own sys tem. From such causes arise a variety of pa thologicall changes in the fwtus, as atrophy, arrest of developement, amputation of limbs, and many other affections, as detailed in the different sections of the present article.
With respect to those which seem distinctly referrible to inflammation arising in the flawl system and invading particular organs, the in stances are very numerous indeed ; especially in the thoracic and abdominal cavities, in which striking indications of violent inflammatory ac tion have been frequently observed, both by the writer and by others.
During the investigations made conjointly by Madame Boivin and M. Chaussier, they met with several eases of well-marked perito nitis, some of which were accompanied by con siderable effusion, which, however, did not exist in others ; but in all there were found nume rous adhesions between the intestines.° Desor mcaux records a case in which a child at birth displayed all the evidences of violent enteritis,f but afterwards recovered. In a case related by Duges, all the abdominal viscera were found agglutinated by a yellow coloured and firm lymph ; there were false membranes on the liver, the spleen, the bladder, &c.; the epiploon was adherent to the intestines, which were ag glutinated into a lump, and were yellow, hard, and thick./ Other instances of this form of in flammation are detailed by Billard,§ Carus,11 Cruveilhier,1 and others.
The stomach and intestinal canal have fre quently been found much diseased at birth. In one instance of a still-born child I found the stomach in a state of intense inflammation, and on its internal surface there were no less than twenty-five patches of ulceration. Dr. C. Johnson of this city found a similar condition existing in the colon : the specimen is depo sited in the Museum of the College of Sur geons, Dublin. Cases of this kind are also de scribed by Billard,*" who mentions an instance in which he found in the duodenum a pedicu latcd excrescence of a red colour and uneven like a strawberry; it was as large as a bean, and in its structure, &c. resembled the vascular
tumours found in the intestines of adults. In the same child there was also evidence of chronic inflammation of the lower portion of the ilium, with thickening of the mucous mem brane, which was of a slate colour.ff In ano ther case examined by the same writer, the ilium and all the colon were found presenting the characters of the disease named by Laennee sclerosis, and consisting in a scirrhous indura tion of the submucous cellular tissue of the in testine. In a ease observed by Cruveilhier the small intestines presented several patches of ulceration, and the coats so thickened that their calibre was quite effaced! Desormeaux thinks, and apparently with good reason, that several of the strictures and obliterations of hollow canals, such as closing of the (esophagus, intes tinal canal, anus, urethra, &c. ought to be re ferred to the influence of former inflammation, to which cause also there is great reason to ascribe many instances of congenital blindness, and especially those in which there is opacity of the cornea.
The liver is not unfrequently the seat of in flammatory and other lesions before birth, a variety of which have been noticed by different writers ; intense sanguineous congestion has been often met with. Billard mentions two instances in which the organ was found soft ened and giving out an odour of sulphuretted hydrogen. It has also been found with tuber cles scattered through its substance at birth.t Iloogeveen describes a tumour which was found attached to the liver of a foetus of six and a half months : it was hard and unequal, and as if composed of particles of soft stone or cherry kernels.: Considerable serous effusion in the abdominal cavity has been often observed.
The organs contained in the thoracic cavity appear to be peculiarly liable to the invasion of inflammatory action, and frequently exhi bit other abnormal conditions also. Cruveil hier goes so far as to say, that lesions of the lungs are so frequent in, the foetus, that in his opinion disease of the lungs carries off as many new-born children as adults.§ The lungs have been found hepatized in still-born children, two instances of which oc curred to Andra1,11 who says he found in ano ther case numerous abscesses in one lung.