Contributions to teratology : undescribed malformation of the lower lip occurring in four members of one family / by J. Jardine Murray.

  • Murray, J. Jardine.
Date:
1860
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Licence: Public Domain Mark

Credit: Contributions to teratology : undescribed malformation of the lower lip occurring in four members of one family / by J. Jardine Murray. 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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    5. Are the sacculi the resnit of intra-uterino disease of the labial glamls? Some considerations fMVour this view. Surgeons are aware that the labial, like other mucous glands, are frequently tiio scat of cystic disease. In the ' Guy's Hospital Reports' for 1859, Mr. Birkett has recorded an iufcei'esting case of labial cyst, occupying the middle of the prolabinm of the Imver lip, a little to the left of the mesial line.* The peculiarly wide and crescentic openings of the sacculi, however, and the fact that in all four individuals they are so perfectly uniform in appearance and symmetrical in position, seem opposed to such an explanation. Congenital malformations are sometimes evidently due to disease of the ovum or fojtus, and [)robably are often to be attributed to the male and female reiiroductive elements having been affected prior to the act of conception; but assuredly the most common explanation is to be.fonnd in impeded or arrested development of the foetus, from some remote or unknown cause. Now, if we suppose the sacculi to bo consequent on intra-uterine disease of the labial glands, it is to be noted that in each of three members of the family which forms the subject of this paper, we have two malformations—one (hare-lip) due to arrest of development, and the other (sacculi in lower lip) caused by intra-uterine disease. But there is ample proof that intra-uterine disease may co-exist with arrested development of the foetus.f A.t my request. Professor Goodsir very carefully examined the sacculi; and, while he concurred with me in thinking them ex- • Guy's Hospital Reports, third series, vol. v. pp. 2G6, 267. t Malformations due to arrested development may co-exist with malformations caused by intra-uterine disease of the foetus. In April, 1857, while house-surgeon in the IJoyal Maternity Hospital of Edinburgh, I delivered a half-witted girl of a monsti'ous child, presenting malformations of both kinds. As the case is interesting and illustrative, I may bo permitted to insert the following extract from my notes:— J. J., aged twenty, has never previously had a child or miscarriage. Labour tedious; lifter tlio head and arms had been expelled, the greatly enlarged abdomen of the chilO remained flrraly impacted witliin the maternal passages, and considerable extractive force had to be employed in order to remove the mass. Patient recovered without a bad Byniptom. Child still-born, full-grown, female. It is the subject of several malformations. Tliere is what may properly hs re arded as spina-biflda of Uie occiput, arising from deficiency of tlie occipital bono. On eaoli hand there is an additio :al finger, butwitli- out any additional metacarpal bone. Tliere is Assure of the soft palate. A flcsliy tumour is attached to the margin of the tongue. But the most remarkable feature of this case is the enormous size of Mio abdomen, caused by cystic dise.ase of the kidneys. Jioth kidneys are affected in a manner precisely similar, and they are of equal size. The right kidney, being carefully dissected from its position, is found to have its vessels and ureter quite nonnnl in size and appearance. The peritoneal covering and the iibious coat arc readily separated from tho uniformly smooth external surface of the organ. 'I liis kidney weighed 13 oz. r,r, 23. On making a clear section, (he whole substance