Variola, Measles, and various cicatrices have been noticed on the foetal integuments. To this head also pertains pemphigus and various vesicular eruptions, the vesicles of which contain a livid, sero-purulent fluid, are converted into ulcers, and may be traced to syphilitic causes. We also find ecchymoses, petechial suffusions of the skin, shallow or elevated naevi, of a brown or livid hue, and of different sizes. The subcutaneous cellular tissue is the seat of anasarca and of many of the above-mentioned tumors and morbid growths; shortly after birth, it is frequently attacked with induration.

The serous membranes are found more frequently inflamed than any other tissue, or the previous existence of inflammation in them is evidenced by adhesions of the organs which they invest; these, undoubtedly, give rise to many of the anomalies in the position of these organs, which are in part at least looked upon as the consequence of original malformation and arrest of development.

Peritoneal inflammation is, doubtless, the most frequent, and it is upon this fact and upon the adhesive termination of the disease, that Simpson bases his views regarding many of the anomalies that are commonly considered as cases of arrest of development. Inflammation of the pleura and pericardium are less frequent.

Among the mucous membranes, that of the alimentary tube is the chief seat of disease, as we shall have occasion to explain more fully in the sequel.

In addition to the above-mentioned fractures, dislocations, and spontaneous amputations, we find the osseous system liable to suppurative inflammation (caries), hyperostosis, and an exuberant deposit of callus, an arrest in the process of ossification, which is allied to rhachitism (rhachitis congenita).

The morbid processes in the muscular system which we chiefly meet with, are contractions; they depend mainly upon diseases of the nervous centres.

The heart is liable to be affected, in the first instance, by pericarditis; in the second, by endocarditis. It is very remarkable, that the relation of the latter to the cavities of the heart is the reverse of what occurs after birth. The dilatations and valvular affections observed at the left ventricle and its arterial orifice in the adult, as a consequence of endocarditis, are here found to attack the right ventricle and the valves of the pulmonary artery.

The stenoses observed in the latter, which originate in a morbid metamorphosis of the valves, are to be carefully distinguished from cases of arrest of development occurring here, especially in the shape of atrophy of the pulmonary artery, resulting from anomalies in the structure of the heart.

The ductus Botalli is in rare cases liable to an aneurismatic dilatation, and in this respect resembles the aorta in extra-uterine life.

The brain and the spinal cord are particularly subject to disease in the foetus; and these affections are undoubtedly the cause of many defects and malformations of the brain and spinal cord, their membranous sheaths and osseous cases, and of defect and malformation of other organs which have hitherto been considered as anomalies of original development.

Thus we observe hypertrophy of the brain, which in rare cases attains such an extent as to cause the development of the cranium to appear entirely arrested.

Apoplexy occurs very rarely as hemorrhage within the substance of the brain; but we often find both in the foetus and the new-born infant a vascular apoplexy, and extravasation into the tissue of the membranes and into the cavity of the arachnoid.

Inflammation And Its Consequences

Inflammation And Its Consequences, inflammatory softening and complete liquefaction of the brain, are much more frequent. These and hydrocephalus are doubtless the commonest cerebral diseases of the foetus, and upon the former the defects and numerous malformations depend which are found in hydrocephalic foetuses.

Hydrocephalus and hydrorrhachis are, in the foetus as at a later period, the result of repeated exudative processes affecting the investments of the cerebral cavities and the spinal canal. They are well known often to attain such a degree, that not only the dilated and imperfectly ossified cranium offers an obstacle to parturition, but that the brain and the spinal cord are gradually destroyed by compression; that they are ruptured at an early stage of embryonic life, or are dislocated in various directions, and forced out of the cranium at later periods.

In the respiratory apparatus of the foetus we find that the pulmonary parenchyma and the bronchi occasionally become diseased. The former is said to have been found in a state of hepatization, and even abscesses have been seen in the lungs. The bronchi are frequently charged with mucus, and atelectasis neonatorum is probably caused by a mere catarrhal affection of the mucous membrane, and an obstruction of the capillary bronchi by mucus. (Vid. Vol. III., Acute Catarrh of Respir. Org).

The thymus gland of the foetus may, according to Veron, be attacked by inflammation and suppuration.

In the digestive apparatus, the peritoneum, the entire intestine, and its appendages may become diseased during uterine existence.

The peritoneum is frequently the seat of inflammation of an acute or chronic character, causing exudations, that vary in quantity and quality. It may be limited to one portion, or be universal. It not only induces thickening of the peritoneum, but also adhesions among the abdominal viscera, and between them and the parietes; the sooner it sets in, the more it is likely to operate as the cause of numerous anomalies in the abdomen, which have been hitherto considered as cases of arrest of development. (Simpson.) The inflammation may originate in unknown causes, or in such as are anatomically demonstrable, as constriction of the intestine, hemorrhage of the liver into the peritoneal cavity, extravasation of the contents of the intestines, or of urine; the latter may occur at a very early period, for it has been noticed in a foetus of four months. It sometimes kills the foetus before maturity, at others death ensues shortly after birth.

As regards the alimentary tube, both hyperaemia of its mucous membrane and anaemia, with waxy paleness and softening, have been frequently observed. The latter affection is of particlar importance in the foetus. The former not unfrequently attains such a degree as to warrant the application of the term apoplexy; it is generally associated with hy-peraemia of other abdominal viscera and general plethora, and may be accompanied by ecchymoses in the tissues and extravasation of blood into the intestinal cavity.

Inflammation and the allied processes are generally limited to the follicular apparatus of the ventricular and intestinal mucous membrane, which are comparatively very much developed. The former occasionally presents a hemorrhagic fusion (erosion) of the follicles in a very marked degree; the follicular apparatus of the intestinal mucous membrane is still more frequently diseased. In the small intestine, the glands of Peyer are chiefly found more or less swollen, reddened, and of a fleshy sarcomatous appearance, or pale, i. e. yellow or grayish-red, containing like the solitary follicles, a variety of reddish or grayish, more or less dense, opaque, milky or curdled, serous, flocculent fluids. These morbid enlargements of the intestinal follicles, caused by tumefaction and imbibition of the tissues, and the presence of a variously modified product, are here too undoubtedly (vide p. 78) closely associated with anomalies in the vital fluids, with morbid conditions of the mesenteric glands, abnormal enlargement of the thymus, or with tumefaction of the spleen, but their real nature remains an enigma. The indurated swellings of the Peyerian glands occasionally resemble closely the typhoid infiltration found in adults, and may indeed result, if not from an identical, at least from a very similar process. Follicular tumefaction also occurs frequently in the large intestine of the foetus and the new-born infant; and, as in the adult, without any coexistent affection of the small intestine. The follicles appear much reddened, the entire mucous membrane is swollen, and invested with a yellowish-white secretion.

In very rare cases we meet with a diffused croupy inflammation, and a corresponding product in the intestinal mucous membrane.

The processes which we have just considered, do not appear to lead to ulceration in the foetus; still there are cases on record of extensive ulcerative affections of the oesophagus and the entire alimentary tract.

Tumors and excrescences have been observed on the internal surface of the intestine, as well as callosities of the interstitial cellular tissue, especially of the stomach.

The foetal liver is very often the seat of hyperaemia, which, on account of the delicacy of the hepatic tissue, easily degenerates into apoplexy with rupture.

Various infiltrations of the hepatic parenchyma may form even during foeta existence, and we thus find the fatty, the waxy, the lardaceous liver accompanied by the characteristic enlargement, in which the left lobe, which at that period is comparatively of large dimensions, necessarily participates.

In the same manner, the spleen of the foetus may suffer; it is often found in a state of acute or of chronic tumefaction, presenting in the first case looseness, in the second, remarkable condensation, resistency, and frangibility of texture. Tumors of the spleen bear the same import as in the adult, and result from the relation existing between the spleen and dyscrasic conditions of the blood. They occasionally attain a considerable size.

The salivary glands, and especially the pancreas, are very rarely affected in the foetus; the cancerous induration of the pancreas noticed at page 140 must be considered as extremely remarkable.