Manual of antenatal pathology and hygiene : the foetus / by J.W. Ballantyne.

  • John William Ballantyne
Date:
1902
Catalogue details

Licence: Public Domain Mark

Credit: Manual of antenatal pathology and hygiene : the foetus / by J.W. Ballantyne. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    some of the chorionic villi reach down as far as the spongy layer; it may therefore be said that here is the fcetal side of the traumat- ism. At the same time, it must be borne in mind that changes have been occurring in the villi, during the last weeks of pregnancy, which tend to obliterate the vessels, and so lessen the risks following the separation (haemorrhage and septic absorption). As stated by Eden {Journ. Path, and Baderiol., p. 466, Jan. 1896), the villi which become embedded in the serotina are devascularised and function- less; further (ibid.,]). 268, Dec. 1896), the same author has found that the foetus takes decided measures to cut itself off from its placenta during the last weeks of intrauterine life. It is therefore very probable that by natural processes the separation of the placenta is prevented from bringing much risk to the foetus, and we cannot look upon the uterine aspect of the placenta as an exposed foetal surface; but, artificially, the obstetrician produces an exposed surface when he cuts the cord, although he diminishes the risks resulting from it (haemorrhage and septic absorption) when he ligatures it before section. It is evident, then, that birth is traumatic. In the best circum- stances, however, by a wonderful series of precautions, the dangers of the traumatism are reduced to a minimum, justifying the descrip- tion of it as physiological. It is physiology, however, which very readily passes over into pathology; for both the pressure effects and the separation results may very easily set up morbid changes in the foetus, or bring pathological conditions as their sequelte. These morbid processes will be described in the next chapter. Physiological Readjustment at Birth. Birth, then, is the more or less traumatic transition from the protected semiparasitic life of the foetus to the more exposed and ultimately independent existence of the infant; but traumatism is not the only occurrence in the physiology of this neonatal period of life, for it is during the three or four weeks that follow birth that the organs of the new-born infant take up the work now thrust upon them, and formerly performed in great part by the placenta. It is a time of readjustment, of adaptation, of alteration, and of metamorphosis. Birth, it must be remembered, does not mark a beginning, but a stage in life's progress; at any rate, it marks only the beginning of a stage—the beginning of postnatal life. The transition is abrupt, and the surroundings are very unlike, nevertheless the life is con- tinuous. The more perfect and complete our knowledge of the physiology that precedes and of that which follows birth becomes, the more clearly and undeniably this principle is established. There are differences between the life of the foetus and that of the new-born infant; but by means of a marvellous series of adaptive mechanisms, the life that is before birth becomes continuous with the life that is after birth, and the transition is accomplished with a minimum of change and with but a passing dislocation of function. Some only of the organs of the infant are truly born at birth, in the sense that they begin