It has been already described in this work (see CELLULAR TISSUE, p. 516), and it ap pears only necessary to add here that the affection is sometimes found fully established at birth. " Many children," says Andral," " come into the world with this affection," and we have the testimony of I3illardtt and others to the same effect. Jaundice has been more frequently found than any other affection in conjunction with this edema of the cellular tissue. Of seventy-seven cases examined by Hillard, thirty were affected with jaundice.* For a very full account of this subject see Graetzcr, die Krankhcitcu des Foetus : section sclerodcrma.
Cutaneous affeetions.—Lesions of the skin are probably the most numerous class of affec tions to which the foetus in utero is liable.
Some of these appear to be in a great mea sure mechanically produced in consequence of the occurrence of other diseases, as in cases of spina bifida, encephalocele, and other tu mours of the head. In these instances the skin covering the tumour is first attenuated as it is distended, and subsequently it disap pears altogether, and not unfrequently becomes ulcerated. In some instances the injury observed on the skin is the result of inflamma tion either attacking the skin itself or the mem branes of theovum; in the former case abscesses may form and ulceration be produced. I have frequently seen instances of both, and also very distinct cicatrices, which must have been a considerable time in existence. 011ivier (d'Angers) describes a remarkable case of ulce ration on the legs of a child born with clubbed feet.t I have more than one instance in my museum of destruction of the skin from adhe sion having taken place between the fetus and the membranes. Excrescences from the skin have been observed by the last-named author, Billard,1 and others. The writer once attended a lady who gave birth to a very fine healthy child with two excrescences attached by pe dicks over the third phalanx of each little finger. Nsavi of different kinds existing at birth are matters of common observation, and in not a few instances petechite have been observed in the form usually denominated pur pura hremorrhagica.§ Very many instances of the eruptive diseases have been noticed in the immature fetus and child at birth. Vogel and Rosen mention in stances of chilbren born with the traces of measles, and Guersent saysll he saw an infant born with the eruption on it, having taken the disease from the mother.
In the course of the last year I attended a patient who was delivered a month before her time, when just recovering from an attack of scarlatina; the child's skin exhibited the erup tion in several places: it recovered.
Small-pox has been observed on the child at birth and under remarkable circumstances, as in cases where the mother had not been affected with the disease during gestation. See cases by Jenner, Med. Chir. Trans. vol. i. p. 269 ; and a very remarkable one by Mead, in which " a certain woman who had formerly had the small-pox, and was now near her reckoning, attended her husband in the distemper. She went her full time and was delivered of a dead child. It may be needless to observe that she did not catch it on this occasion, but the dead body of the infant was a horrid sight, being all over covered with the pustules ; a manifest sign that it died of the disease before it was brought into the world." Works, edit. 1767, p. 253.
Bullard' mentions having seen in the Museum of Guy's Hospital a foetus of six months covered with pustules of small-pox, which was born when the mother was just recovering from the disease.
" Mary Gatton had confluent small-pox in the seventh month of her pregnancy ; eighteen days from the first attack of the eruptive fever she was taken in labour and delivered of a child, which seemed to have been dead five or six days. Its body was covered with confluent small-pox. The pustules were white and full of matter, and from their size seemed to have nearly attained their maturity."t " A lady was inoculated in the seventh month of her pregnancy, and on the ninth day from the accession of the eruption, which was moderate, she received a fall; from that period the motions of the child were no longer per ceptible : in eight days after she was taken in labour, and delivered of a dead child covered with a great quantity of variolous pustules, which were prominent and in a state of suppu ration.1 Pemphigus has been observed on the child at birth by Lobstein,§ Joerg,I1 and others.
When the system of either parent retains a taint of syphilis, the child very frequently exhi bits at the time of birth unequivocal evidence of being contaminated by the disease, and sometimes of having already fallen a victim to its ravages; though in the majority of such cases the children are born alive, often appa rently healthy, and do not exhibit any appear ance of disease for a few weeks.