Case of thickening and deep fissures of the skin in an infant at birth / by Alexander Keiller. Notes of cases of intra-uterine cutaneous disease analogous to that described in the preceding article, with remarks on the pathological nature of the affection / by J.Y. Simpson.

  • Keiller, Alexander, 1811-1892.
Date:
[1843]
Catalogue details

Licence: Public Domain Mark

Credit: Case of thickening and deep fissures of the skin in an infant at birth / by Alexander Keiller. Notes of cases of intra-uterine cutaneous disease analogous to that described in the preceding article, with remarks on the pathological nature of the affection / by J.Y. Simpson. Source: Wellcome Collection.

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    many unpleasant forebodings which she had for months enter¬ tained regarding the condition of her unborn offspring would yet be sufficiently accounted for. Knowing my patient to be of an extremely nervous temperament, and finding the os uteri undilat¬ ed. I was induced to consider the case as one of simple puerperal neuralgia, and accordingly prescribed an anodyne draught with castor oil, which, with rest and quiet, appeared quickly to subdue the uterine irritation, and with it the previously almost intolera¬ ble abdominal pain. On the evening of the 28th, however, the regular pains of la¬ bour commenced, and continued slowly to progress until nine a.m. of the 29th, when the birth of a male child, the singularly- conditioned subject of the accompanying sketch, was effected. During the first stage of parturition, and previous to the dis¬ charge of the liquor amnii, the hard and globular presentation sufficiently indicated a head; on rupturing the protruding mem¬ branes, however, and bringing my fingers into immediate contact with the presenting structure, in order to ascertain its relative position, I was not a little astonished to find that, instead of the smooth, soft, yielding scalp, a rough, hard, and irregularly fissur¬ ed surface presented itself, the usual guides to position—the fontanelles, sutures, and ears—being altogether undistinguishable. Although at a loss to determine what the advancing structure consisted of, its unyielding serrated-like feel led me to anticipate the existence of an anencephalous development, or some other abnormal condition of the bones of the skull. On delivery being accomplished, however, a sufficient excuse for any previous un¬ certainty immediately presented itself in the hard, preternaturally-- thickened and deeply rent dermoid covering, not only of the head, hut of the whole body, which seemed as if completely enveloped in an irregular coating of cartilaginous structure. So deep were the numerous fissures in the hard and much thickened scalp, that in appearance, as well as to the touch, they very much resembled the sutures, or rather the serrated edges of the bones, of a dis¬ articulated adult skull. The skin of the face, in like manner, consisted of ossified-look- ing portions, also irregularly fissured; the nose and ears were re¬ presented by mere tubercular knobs without apertures; the eye¬ lids were altogether undeveloped; red fleshy-like cushions occupied the eyeless orbits; the mouth seemed large and gaping; the tongue was voluminous and protruding, and their ill-starred owner, as if to render his hideousness still more complete, was yelling most vociferously. The skin of the trunk and extremities was equally hard and cartilaginous, though not so thick as that of the head and face; the rents, or cracks, were so extensive on the abdomen, that it appeared, in several parts, altogether void of dermoid covering.