FCETAL PERITONITIS.
The most common lesion is peritonitis, which has been studied particu larly, by Simpson and Lorain. Out of 106 still-born infants, Lorain has found it 10 times, and out of 19.3 infants, born alive, but dying in a few hours or a few days after birth, peritonitis, sometimes simple, sometimes complicated with meningitis, multiple abscesses, or erysipelas, has been found 40 times. (Lorain.) As we shall see, the existence of peritonitis in the fcetus and the newborn is due to the same cause which causes it in the mother after delivery, namely. puerperal fever, which attacks the fcetus first, and the mother afterwards.
Simpson, previous to Lorain, had collected 2:3 cases, 2 of them per sonal, some borrowed from Allan, 4 cases, from Billiard, :3 cases, from Banks, Fisher, Fairbain, Cruveilhier, Scott, Viron, Brachet, Chaussier, Pugh and Carus, each one case, a total of 10. Finally, 4 cases of chronic peritonitis, 2 from Billiard, and 2 from Andral and Morgagni. Since then, such cases have multiplied, and there is no obstetrician at the head of a large hospital who does not each year observe a great many of these cases.
Pathological Anatomy. —The nature of the effused fluid varies consid erably. Sometimes it is purulent, mixed with more or less plastic lymph. Sometimes the lymph exists alone, or mixed with a large quantity of serum. Sometimes there are non-adherent flakes and membmnous deposits of va rious sizes, floating or adherent; sometimes. soft and pulpy, forming more or less solid adhesions, or even true false-membrane, gluing together, in one unique mass, •the abdominal organs. Concomitant lesions are thickening of the intestines, softened liver, persistent infiltration, inflam matory nuclei in the lungs, bloody clots in the abdominal cavity, pro ceeding from a rent in the liver, enormous development of the spleen, peritoneal adhesions, mesenteric glands enormously swollen, little hemor rhagic effusions in the different organs. Generally the whole peritoneum
is affected; at other times only partially. The peritoneum may be hypertrophied and indurated.
cites, successively, hard work on the part of the mother, fatigue, cold, dampness, a physical lesion during gestation, peri tonitis in the mother during pregnancy, syphilis—especially, anomalies of abdominal viscera, and accidental effusion of irritating liquids, on the peritoneal surface itself—urine, and rents of the liver. Lorain does not believe in the very great influence of syphilis. He thinks the peritonitis due to the puerperal fever which is manifested as in the mother, by the peritonitis, and is reproduced after birth.
Symptoms. — The symptoms are more than obscure, the mother generally having experienced only the cessation of movements, accompa nied sometimes by false pains, followed by the signs of the death of the fcetus.
is definitely known.
Periods of Retal Life when Peritonitis without speci fying, said that he had seen incontestable pathological alterations in the lungs, liver, peritoneum, and other parts of the body from three months. According to Simpson, it may develop at all ages, even at term, the in fants being born alive, succumbing from a few hours to one or two days after birth. Finally, Lomin has observed in the new-born, hydrocele of the tunica-vaginalis, erysipelas, phlegmon, phlebitis and arteritis of the umbilical vessels.