On visceral hæmorrhages in stillborn children : an analysis of 130 autopsies being a contribution to the study of the causation of stillbirth / by Herbert R. Spencer.

  • Spencer, Herbert R. (Herbert Ritchie), 1860-1941
Date:
[1892]
Catalogue details

Licence: Public Domain Mark

Credit: On visceral hæmorrhages in stillborn children : an analysis of 130 autopsies being a contribution to the study of the causation of stillbirth / by Herbert R. Spencer. Source: Wellcome Collection.

    117/130 (page 291)
    born suddenly by a single pain, dead, and presenting numerous visceral haemorrhages ; here there was not time for the production of asphyxia as usually understood. Moreover, there is the fact, that in the absence of all signs of asphyxia, pressure from without—either by instruments, the parturient canal, or the doctor’s hand— may give rise to haemorrhage at the part pressed upon. Again, I have seen children born easily, in a state of the most intense livid asphyxia (in cases of prolapse of the cord, congenital disease of the heart, &c.), and show- ing no haemorrhages on post-mortem examination. It may, I think, also be stated generally that where the labour is easy, in spite of asphyxia in the child, the haemorrhages will be absent or of slight degree. It is, moreover, a daily experience to find children born profoundly asphyxiated, but alive, and easily in a few minutes provoked to healthy and vigorous life. Many of the children described in the foregoing pages have shown no clinical sign of asphyxia just before birth, and yet have been born dead and show- ing visceral haemorrhages. If we consider, on the one hand, the force which the uterus exerts on the body of the child—sufficient to para- lyse the arm of a strong man ; and on the other hand, the softness and delicacy of the infant’s tissues and the readiness with which it resents the slightest injury ; I think it far more reasonable to attribute the death, in cases in which there is haemorrhage, to shock as a result of the injuries to the viscera than to asphyxia and asphyxia alone. When combined, however, with the other causes, asphyxia will no doubt render the haemorrhages more frequent and more severe. Besides the general condition of asphyxia it is possible that a vaso-motor influence is exerted on the viscera through the injuries to the central nervous system, but of this there is no clear evidence in the cases before us. Pressure upon veins (e.g. jugular and spermatic) will cause a congestion of the distal area, and thus favour the vol. xxxiii. 22