Volume 1

A treatise on the science and practice of midwifery / by W.S. Playfair.

  • Playfair, W. S. (William Smoult), 1836-1903.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the science and practice of midwifery / by W.S. Playfair. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    296/432 (page 272)
    [Paict II. would interfere with the circulation through the cord. Some- times, when intra-uterine amputation occurs, the separated portion of the limb is found lying loose in the amniotic cavity, and is expelled after the child. Cases of this kind have been recorded by Martin, Chaussier, and Watkinson. More often no trace of the separated extremity can be foimd. The explanation probably depends upon the period of utero-gestation at which amputation took place. If it occurred at a very early period of pregnancy, before the third month, the detached portion would be minute and soft, and would easily disappear by solution. If at a later period, this could hardly happen^ and the detached portion would remain in utero. In cases of the latter kind cicatrisation of the stump has often been observed to be incomplete. Simp- son pointed out the occasional existence of rudimentary fingers or toes on the stiunp of an amputated limb, such as are seen on the thighs in fig. 89. These he attributed to an abortive reproduction of the separated extreriiity, analogous to what is observed in some of the lower animals. This explanation has been contested with much show of reason. Martin believes that the reproduction is only apparent, and that the rudimentary extremities are, in reality, instances of arrested development. The constricting agents interfered with the circulation sufficiently to arrest the growth of the limb below the site of constriction, but not sufficiently to effect complete separation. If constriction occurred at a very early stage of development, an appearance similar to that observed by Simpson would be produced. It does not follow, however, that all cases of absence of limbs depend on intra-uterine amputations. In some cases they would appear to be the result of a spontaneous arrest of development, or of congenital monstrosity. Mr. Scott • relates a case in which a distinct hereditary tendency was evident, and here the deformity certainly could not have resulted from the constriction of amniotic bands. In this fiimily the grand- father had both forearms wanting, with rudimentary fingers attached ; the next generation escaped ; but the grandchild had a deformity precisely similar to the grandfather. Death of When from any cause the foetus has died during preg- fa-uis. nancy, it may be either soon expelled, or it may be retained ' Obsf. Trans, vol. xiii. P- 91-