ACTION OF THE MATERNAL BLOOD ON THE VITALITY OF THE RETUS.
We have seen, in the article on the respiration of the fcetus, that there is an exchange of materials between the fcetus and the mother through the placental villosities. As Zweifel, Gusserow, Runge and Porak, have shown, certain soluble salts (salicylic acid, iodide of potassium, benzoic acid), certain poisonous substances (chloroform, ether, alcohol) may pass directly and naturally from the mother to the child; certain forms of virus, certain miasms (variola, syphilis, malaria), may be transmitted by the same, from the mother to the fcetus. Finally, the gaseous inter changes are particularly apt to be produced, the fcetal blood-glo bule taking oxygen from the maternal blood-globule. But, on the other hand, it appears from the experiments of Zweifel, of Zunz and of Andreas FlOgyes, that when the maternal blood, from any cause, cannot renew its oxygen from the external air, if the maternal blood corpuscle is intact, and preserves its absorbing power, it in its turn borrows oxygen from the richer fcetal blood and thus endangers the life of the fcetus. If the ma ternal blood corpuscle is altered, or if it has lost its absorbing power, it does not take up the fcctal oxygen, and the fcetus, consuming little, con tinues to live more or less time after the death of the mother. It appears then that whatever interferes with the exchange of gases and nutritive materials between the fcetus and the mother, is fatal to the former.
Then the utero-placental circulation may be obstructed either in the uterine vessels, in the placental villosities or in the cord. It is thus that uterine tumors, peri-uterine tumors, diseases of the placenta, bloody effu sions, changes in the villosities, degenerations, may act, as also maternal diseases, pyretic or apyretic, gravido-cardiac accidents; certain toxic sub stances, phosphorus, lead, arsenic; violent deaths, asphyxia, syncope, finally all the causes which determine the premature contractions of the uterus or obstruct its development; also lesions of the cord.
But in a certain number of cases the fcetus succumbs without any catu3e being found, and this at several consecutive pregnancies (13 times in a case known personally to us; it was only in the 18th pregnancy that she had a living infant, and indeed it was born at 8 months). In these cases,
the young, strong and healthy women were married to strong and vigor ous men. Nevertheless, most frequently the cause of death of the fcetus may be found, but authors are not agreed on this point.
Ruge, in an interesting article, " uber den fcetus sanguinolentns," states that most authorities believe syphilis to be the usual cause of fo3tal death, while Simpson believes that it is only a secondary cause, the primary being the existing peritonitis.
According to Ruge, the fo3tus sanguinolentus, or the macerated fcetus, is almost always the outcome of syphilis.
Leopold believes that the habitual death of the fcetus is due: 1. To syphilis; 2. To anemia; 3. Chronic diseases of the mother; 4. Heredi tary tendencies. [In 1883, in an article on " Habitual Miscarriage" we tabulated the causes of fcetal death, as follows: 1. Syphilis; 2. Maternal anemia; 3. Uterine disease, and disease of the uterine appendages; 4. Uterine displacements; 5. Chronic cellulitis and peritonitis; 6. Laceration of the cervix; 7. Intermittent fever; 8. Chorea; 9. Bright's disease; 10. Tumors of the uterus, and in its neighborhood; 11. Poisoning from me tallic substances, lead, arsenic, etc., seen particularly in workers in the arts where these metals are used; 12. Reflex conditions. These latter, we stated, may have their outcome either from the nervous system, in general, or from the uterus and its appendages, in particular. There are some women so delicately nurtured, so highly impressionable, as to react to the slightest nerve stimulus. Like hot-house plants they must be watched and tended, lest the slightest influence, outside of their accus tomed habitat, affect them unfavorably. Gestation with them is often toxic. The uterus repels the impregnated ovum as it would a foreign body.