Some remarks on the causes of amputation of foetal limbs occurring within the uterus / by W.H. Gatty.

  • Gatty, W.H.
Date:
[1850]
Catalogue details

Licence: Public Domain Mark

Credit: Some remarks on the causes of amputation of foetal limbs occurring within the uterus / by W.H. Gatty. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    SOME REMARKS ON THK CAUSES OF AMPUTATION OF FCETAL LIMBS OCCURRING WITHIN THE UTERUS. By W. H. GATTY, M.R.C.S. Read on Thursday, November 28, 1860. The pathology of intra-uterine ampu- tation was until the last few years so completely enveloped in darkness, that, although these imperfections have been observed from time immemorial, still so little has been known of the manner in which they were produced, that many Persons, among whom was the great Taller, entertained the opinion that they were always the result of imperfect I development, alleging, in support of I this opinion, that there was not one case : recorded in which the “ amputated hand I or other limb had been fovmd separate • I from the rest of the body, in the mem- ' branes of the foetuswhilst others, I amongst whom were Richerand and Desormeaux, regarded them as a patho- 1 logical change in a perfectly developed 1 body, the result of inflammation and I f gangrene. It was not, indeed, imtil the I following case occurred to Dr. Mont- I gomeiy of Dublin, that the true nature < of this change was foimd out; it was a f case of abortion occurring at the fifth ' month. The fallowing is his descrip- ' tion of the foetus:—“The head was : misshapen and monstrous, the brain ■ towering upwards like a helmet over the head, and covered only by integu- r ment; but the circumstance deserving (of especial notice was the appearance fof complete ligaments surrounding the llimb; and on examining them closely 11 found that they consisted of distinct -shreds, passing from both hands down- 1 wards to the legs: at one end they had ' formed a complete ligature round the middle of each hand, causing a dis- tinct depression where it passed, the part of the hand below it being almost completely imdeveloped : from the hands these cords descended to the legs, which were crossed, and, surrounding them, just above the ankles compressed them so tightly that fuUy two-thirds of their whole thickness were thereby divided, withoiU, however, causing any breach in the skin ; nor was there the slightest appearance of disease, or even discolouration of any of the parts; but the feet were, like the hands, imperfectly developed and misshapen.” Since that time many more cases of a similar character have been ob- served,—some of them where the am- putations have been complete, others where they have only been partial; but most of them tending to confirm the opinion of Dr. Montgomery, that they are effected by the application of a ligature round the limb, which by its pressure gradually causes the division. As examples of the first class of cases, or those in which the amputation had been completed, I will adduce the fol- lowing :—Schwabe mentions a man who had only a small stump for a left arm, and lived twenty-eight years; also a man who had only short stumps for lower extremities, but was married, and had healthy and well-formed children. Nettekovan mentions a girl, three weeks old, with deficiency of the lower two- thirds of the right fore-arm ; and a child, twelve yeai-s old, with defect of the