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Acephalous FœtusSource: Provincial Medical Journal and Retrospect of the Medical Sciences, Vol. 5, No. 113(Nov. 26, 1842), pp. 169-170Published by: BMJStable URL: http://www.jstor.org/stable/25491639 .

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CEREBRAL AFFECTION AFTER SCARLATINA.-ACEPHALOUS FMITJS. 169

is, doubtless, to distinguish between a mild case of the

Indian and a severe case of the English cholera.

In the first stage of Asiatic cholera, or the state of

collapse, the general aspect is altered-the body con

tracted (a man appears to be altogether a smaller

man than he was before the attack); the countenance

and the eye have lost their expression; the manner is

peculiarly piteous and imploring; the voice is husky, witlh an odd whine; the patient appears altogether helpless ; the liver and kidney secretions are arrested, and that of the intestinal canal altered; there is

an almost constant oozing of (apparently) serum from

the anus; and, whenever I tried it, five grains of

calomel taken every four hours had no effect; it was

not absorbed, nor did it act on the bowels as a purge.

In the second stage, or state of reaction of those

patiqnts who recover, they appear, first, feverish; next, the liver begins to furnish unhealthy bile (the

first improved appearance in the motions is a dark and afterwards a green color) ; then the excessive thirst abates, and they begin to take nourishment, to

pass urine, and to improve in every respect.

The sign most to be depended upon when a child is attacked, is a blue ring round the sunkeni eyelids.

Although I may have failed to define the pathogno.

monic appearances, yet they constitute an alteration

from the natural aspect, manner, and voice, which

alterations, when once seen, cannot be easily either

mistaken for anything else or forgotten. In the English cholera, though a patient may be

upwards of sixty hours without passing any urine, the

symptoms and general appearances are very different from those of tlle Indian cholera.

CASE II.-August 23, 1842.-I was desired to see

William Roe, cowkeeper, Babworth, near Retford, who had been affected during the last three days with

purging. His skin was cold and dark-colored; his

eyelids appeared sunken; his pulse was 60, indistinct; he had frequent vomitings and purgings of a fluid, like

thini gruel, without either color or smell; was restless on his bed, as if from exhaustion; his toes, though

flexed, yet were permanently drawn upwards and

backwards; he had violent cramps in his legs and abdominal muscles; had not passed any urine during the preceding night nor that day; and he was con

stantly asking in a low, hoarse voice for water. He had opium and stimuli, and turpentine frictions.

24. I had a message from him; " he had not passed

any urine, but was rather better."

25. Visited him; found him still stronger, and he had passed (at twice) three or four ounces of urine.

27. Found him recovering. This man had been working in the harvest field;

drinking new ale several days (from the mash-tub);

and he had been exposed in sultry weather (under a

hedge or a tree) to occasional heavy showers. There

was not any appearance in the general aspect, manner,

or voice, of the Indian cholera.

I am, Gentlemen,

Yours, &c., W. ALLISON.

Retford, Nov. 12, 1842.

CEREBRAL AFFECTION SUPERVENING ON SCARLATINA.

By JONATHAN ToOGOOD, Esq., Sentior Surgeon to the Bridgwater Infirmary.

I ami induced to send the following case, which

may perhaps be worth a place in the Journal at a

time when scarlet fever so generally prevails. I re

gret velry much that the state cf the urine was not

carefully noted at the time, which would have ren

dered the case much more interestinig: A boy, aged eleven, had scarlatina mildly, on the

decline of which he took several doses of purgative

medicine. Three weeks after, he was affected with

slight anasarca of the face, swelling about the throat

and left ear, for whichl he was ordered fomentations

and a dose of calomel, which operated freely; but

during the whole of that day he was sick, vomited

several times, and complained of headache. On the

following morning the pain in the head was much in

creased, his visioni became very indistinct, and he was

comatose. His pulse was slow, soft, and languid, and

he was observed occasionally to be affected with spas

modic twitches. Local bleedinig and cold applications

were directed. Four hours afterwards the coma had

much increased, he became quite flexed, and had a

violent convulsion. At this time the pulse was small,

slow, and languid. He was bled from the arm to ten

ounces, the head shaved, and a dozen leeches applied.

He had no other convulsion, but the pain in the head

still continuing, and the blood being much buffed and

cupped, six ounces more were taken at the expiration

of five hours. During both bleedings, the pulse rose

both in strength and frequency. Cold applications

were constantly applied to the head, and two grains

of calomel directed every three hours. On the follow

ing morning he was quite sensible, the sight was re -

stored, but he still complained of some pain in the

head; this was completely removed by local bleeding

and purgatives, and he recovered entirely in a few

days.

ACEPHALOUS FCETUS. TO THE EDITORS OF THE PROVINCIAL MEDICAL

JOURNAL.

GENTLEMEN,-If the following particulars relative to an acephalous child should be considered suffi

ciently interesting, I beg you will give them insertion

in the" Provincial Medical Journal." Yours obediently,

JOHN WICKENS WEST.

Poole, Oct. 29, 1842.

On the 25th instant I was sent for to attend a woman

of the name of Rigless, aged forty-seven, in labor with

her tenth child. In all her previous confinements she

employed a midwife, and gave birth to nine living

children, all well formed. In the early part of her

last pregnancy she experienced a severe fright, and

was consequently under great apprehension that all

would not go on well with her; she, therefore, was

anxious to employ a medical man. Until ten days

previous to her labor, she felt the movements of the

child, but since then they ceased altogether. On the

night of the 25th she was taken in labor, and I was

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170( EFFECTS OF TARIAR EMETIC.-SOFTEN1NG OF THE BRAIN.

summoned soonl after. On iny first examiination I bouind the os uteri dilated to the size of a shilling, the

membranes entire, and a soft dilatable mass presenting, mnore like the breast than any otlher part of the fcetus. The pains were regular, and in about twenty minutes the os uteri became fully dilated, the membranes were ruptured during a pain, and an unusual quantity of liquor amnii escaped. I againi examined, and found the same soft dilatable tumor presenting, but dis covered, oni further examination, the right ear opposed to the side of the pelvis, which immediately convinced

me of the nature of the presentation, although I could not feel the parietal bones, or, indeed, any of the bones of the head. The child was born rithout aniy difficulty, and proved to be a full-sized one, of the

male sex, but acephalous, and did not manifest anly signs of life. The integuments of the face and head

were naturally developed, as were the eyes, nose, and

miouitlh; but the whole was easily compressible into a very smnall compass, being destitute of the ordinary bony formatioin. I was not permitted to examine the child, but am convinced in my own mind that it was perfectly destitute of brain, and bearinig some analogy to a case related in the " Medical Gazette," Jainuary 26, 1833, of an infant totally destitute of braiii, cere

bellumD, or medulla oblongata. In that case there were unequivocal signs of life for the space of eleven days, such as moving the limbs, breathing, and crying; buit in the one I have related life was extinct.

RE MARKSK. In most cases where monstrosity occurs, there is a

disposition on the part of the uterus to expel its con tents durinig the early stages of gestation; but in the case of the acephaloid fwetus there appears to be an

exceptioni, showing, as Dr. Ramsbotham has stated, " that the brain is not essential to our being wlhilst in

utero, for many of these children have arrived at the full intra-uterine size-nay, some are actually larger than the ordinary fretus, as if nature had intended to

compensate for the loss of the braiui in allowing an

exuberant growlth in the body." In the present in stanice the woman had arrived at her full period, aild lhad had, until ten days previous, unequivocal signis of the child being alive. She was so impressed with the idea, since her alarm, that she should have a severe labor, that, on being informed of the defects of the child, she said she was persuaded that something of the kind would prove to be the case. We have no satisfactory proof that deficiency of parts exists from the first development of the fcetus in utero, and the only reason that can be assigned for nature's deviation from the right course is, the effects that particular and sudden impressions on the mind produce during the early stages of gestation. We have many well au tlheniticated cases on record wvhere children have been born witlh various deficiencies-such as ani arm or leg

with a perfect stump, caused, as I recollect anl instanice that occurred in the practice of my father some years since, by a woman being suddenly alarmed by a man soliciting alms, and holding up the stump of his leg. The -woman being theii in the early stages of preg nancy, afterwards gave birthl to a child with a perfect

stumi)p.

o** We fear that Mlr. WVest has

miistakeni the post loc for the propter hoc. His theory is utterly un tenable.-Eis.

EFFECTS OF THE TARTAR EMETIC OINT MENT ON THE SCROTUM.

TO TIHE EDITORS OF THE rROVINCIAL MEDICAL JOURNAL.

GENTLEMiEN,-Thc publicationi of the letter ill your

last weeks' Journal, from Mr. Griffiti, of Oswestry,

on a curious effect of tartar emetic ointment, has in

duced iic to senld you a short history of the following

case, which occurred il iiiy practice a few months

since.

J. D., aged thirty-six, was ordered to use the tartar

emetic ointment, for chronic swelling of the knee-joint

after rheumatism, and told it would produce a crop of

painful pustuiles, which after a few days appeared on

the inner side of the knee; I theni ordered him to con

tinue the applicationi on the outer side; this he did,

and, much to my surprise, it produced a severe effect

uponi the scrotum, which assumed quite a conflueint

character. I directly cllarged him with having applied

the oinitment, or his unwashed hands, to the part, but

he declared lie had not, amid begged for something to

relieve his sufferinig, which he stated to be ten times

worse than the pain from a blister; fomentatiomms,

poultices, &c., were successfully applied. T'he patient was of a spare habit, and had his scrotum muclh re

laxed by conifinement to bed, wlichl probably rendered

it more susceptible of the action of the ointment; but

whether it was carried to that organ by absorptiou, or

was brought in immediate contact witlh it by means of

his shirt, which frequently touched his kiiec and

scrotum alternately, amid possibly gathered enough to

affect the latter, I am still at a loss to kmlow, though I

am inclined to think there was direct conitact with the

oinltment. Last month I saw a similar affection on

the scrotum of a lad fifteen years of age, whose mother

had been rubbing crotoin oil over the abdonmen, amid

had carefully avoided all other parts.

I am, Gentlemen,

You obedient servant,

JOHN B. PITT, M.R.C.S.

MIattishall, Norfolk, Nov. 15, 1842.

MICROSCOPIC RESEARCHES ON SOFTEN ING THE BRAIN.

By Professor GLUGE, of Brussels.

The brain is composed, as every one knows, of

white and grey substances. The white or medullary

substance, when viewed uinder a magnifying power of

250 diameters, appears to be composed of white,

cylindrical, uninterrupted, and elastic corpuscles, which, in virtue of their elasticity, contain nuclei of

about the 1-2700th part of an inch in diameter. It

seems probable that the cylindrical corpuscles are

true canals, the intervals between which are filled

with networks of extremely fine cellular membrane.

The cortical substance is supported by the same net

work, and contains similar but still smaller canals,

which are mixed up with spherical corpusculi.

Having thus briefly noticed the microscopic cha

racters of the nervous tissue, the author passes to

softening of the braiin, which he distinguishes, accord

ing to the color, into-1, a yellowish red; and 2, a

perfect white. The softeiiing sometimes occupied the

white or grey substances exclusively, but in most

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