A treatise on the diseases of infants, founded on recent clinical observations and investigations in pathological anatomy made at the Hospice des Enfans-Trouvés : with a dissertation on the viability of the child / by C.M. Billard ; with notes by Dr. Ollivier ; translated from the third French edition, with an appendix, by James Stewart.

  • Billard, C. (Charles-Michel), 1800-1832.
Date:
1839
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases of infants, founded on recent clinical observations and investigations in pathological anatomy made at the Hospice des Enfans-Trouvés : with a dissertation on the viability of the child / by C.M. Billard ; with notes by Dr. Ollivier ; translated from the third French edition, with an appendix, by James Stewart. Source: Wellcome Collection.

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

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    has been done by some distinguished writers on legal medicine, to the absence or presence of a red circle around the umbilicus, when we are examining the dead body of an infant to determine whether it died before, during, or after birth. This inflammatory redness proceeds from a cause which I will now endeavor to explain. It is worthy of observation that the redness and suppuration were not manifested except in about one fourth of all the cases which form the subject of these researches, and that the umbilical cutaneous ring in children exhibiting this phenomenon, appeared very distinct, and the cord abounding in gelatine was attached by a large surface to the abdomen. Ought we not, therefore, to attribute this inflammation to the projecting of the umbilicus, by which it is exposed to the rubbing of the clothes and the friction of the dried cord ? and can we not find in the gelatine of Wharton, or in the cellular tissue, which together surround the vessels of the cord, the materials of the suppuration 1 This redness is often partiaL and is not manifested except at that portion of the cord which has suffered compression. At other times the inflammation appears and disappears several times, whether the cord remains attached, or whether it has been for some time separated; and it is not uncommon to see it remain for seve- ral weeks, producing an erysipelatous affection on the parietes of the abdomen. In order to avoid the irritation produced by the con- tact of the indurated cord upon this part, we ought carefully to remove a portion where it has dried, and always to apply a com- press upon the umbilicus, through the centre of which a suita- ble opening has been made to allow of the passage of the umbili- cal cord. Since, in the separation of the cord, two phenomena have been presented, in the one case the umbilicus inflaming and sup- purating abundantly, while in the other the separation is pro- duced by a simple desiccation, accompanied sometimes by a slight oozing from the base, but without any real inflammation ; we will inquire in which of the two the cord soonest undergoes separation. The following facts will answer this inquiry. In twenty-one infants of whom I have before spoken, when the cord had fallen off, there were only three with the red circle around the umbilicus. One, aged five days, exhibited this redness with- out suppuration ; another, aged three, had the redness with sup-