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THE PERIOD OF GESTATION.
1201 would not order medicines in the second group unlessI Hollings and Broxholme nor Mrs. Hollings had diathey looked upon them as possessing recognised advantages gnosed the near approach of the event during the Princess The King, however, was over pharmacopoeial or other non-proprietary preparations of Wales’s flying visits to town. The Lofal Committees are not vastly incensed. He thought he saw through these of similar composition. bound to act upon these suggestions, but in practice they excuses, and turned his son, his daughter-in-law, and Instances of their baby out of his London palace. are doing so, and it is very desirable that there should be It is babies untimely born are legion, for the ladies of the more uniformity in the policy of English committees. in the interests of insured persons that there no unreasonable interference with the duties of the doctor towards his patient.
eighteenth century took risks with their eyes open and with a lightness of heart, now only to be equalled among gipsies or proletarians. In 1777, for instance, the wife of a naval officer, afterwards one of Nelson’s admirals, CHILDBIRTH IN THE EIGHTEENTH CENTURY. narrowly escaped giving birth to her daughter in a theatre at where her versatile spouse was acting in the Duenna. ’IT can scarcely be disputed that the eighteenth centuryICork, He I had a passion for the stage as well as for war at sea. held semi-barbaric views as to the puerperal state and wifely « In the middle of the entertainment," according to duties in general. When, for instance, Csesarean section
obviously
should be
t the unpublished memoirs of the daughter in question, had to be resorted to, the mother was, when necessary, mother was taken ill, and escaped as quickly 66 may sacrificed in place of the child, whereas nowadays the " as possible and got home only a few doors distant, mother, as a possible producer of further offspring, is spared i but no one was in to open the door. My father, guessing and the child is sacrificed. The theory of the old medical ran. home in all what had his disguise and occurr’d, jurisprudence was that everything should be done to safe- broke the door before the servant 1 could be awoke open guard the life of an heir; and a mother, as not being an heir, from a fit into she had which fallen fainting by reason was as often as not the victim of her infant’s claims to a " How our ancestors were born, and how the heat." of succession. She was the slave of testamentary dispositions, and at times was compelled by these to give birth to her they died, would form a fascinating volume, but from various motives, are always baby at some stated place. Often, again, during preg- mourners and survivors, reticent as to these desirable data. Even in the case of nancy she was made to suffer bitterly in the cause famous men the cause of death is rarely mentioned. medical of dynastic or family feuds ; and often, when no feud existed, she was bandied about during the period We know that John Hunter died from heart disease, but what of gestation in a manner horrifying to modern notions did the great Joseph Henry Green die from when, like some of decency. It speaks volumes for our ancestresses that hero of antiquity, he said Stopped!"after his pulse had they apparently acquiesced with much cheerfulness in actually ceased to beat ? If these deaths of famous men be A historic document was issued in obscure, how much more impenetrable are the circumstances these arrangements. of their births. ambassadors in 1737 II. to all
by George
,
foreign
England
and to all British ambassadors abroad. Republished for the benefit of the public, it appears as the very scarce pamphlet entitled Letters and Messages, that passed between the King, Queen, Prince, and Princess of Wales ; on occasion of the Birth of the Young Princess." It was sold to a generation in sympathy with Frederick, Prince of Wales, for the sum of 6d., and presents a perfect picture of our ancestors’ attitude towards a mother in posse. Late in July, 1737, the Princess of Wales, wife of the notorious, but not very wicked, Prince Frederick, had been to all appearances seized with labour pains and had been hurried at dead of night from Hampton Court to St. James’s in order that she might become a mother in London. The roads were rough, footpads swarmed in the neighbourhood of what is now the Albert Memorial, the carriages even of the great hung on uneasy springs and ran on heavy iron tyres. Yet despite all this, Prince Frederick endangered his consort’s life in order probably that the child might be born away from the Court and that the witty Queen Caroline might not be present at its birth. The supposition is that of Lord Hervey, whose fascinating memoirs have been so often quoted by Leigh Hunt in his description of the goings on at Kensington Palace when Queen Caroline resided there ("The Old Court Suburb"). On arrival at St. James’s the beds were found to be unaired, and the only lady in attendance was a reputed mistress of the Prince. The pains, however, abated, and a return was made to Hampton Court. This happened on a Monday night or on a Tuesday morning. On the Friday following the pains returned, and again the Princess was rattled to St. James’s, only to return to Hampton Court on a Saturday. On Sunday, however, there could be no doubt about her condition. She was got to London and gave birth to a princess, sister of the future George III. The Prince, writing in the curious Court French of the time, avers that there was no midwife at Hampton Court, and that neither Doctors
____
THE
PERIOD OF GESTATION.
THE determination of the normal period of gestation is a natter of considerable practical importance, but up to the present time no very definite knowledge can be said to exist The problem is discussed by Dr. D. Berry 3n this point. Hart in the current number of the Edinburg7t Medical J01lrnal. An obvious difficulty is encountered at the outset of any inquiry on the subject in that the terminqts a quothe moment when the ovum is fertilised by the spermatozoon -cannot be accurately recognised, for it is almost certain that the male element may remain alive in the female passage for some days, while it is exceptional in the case of human beings to be able to trace a pregnancy to a single act of insemination on a known date. Hence it is necessary in the case of mankind to reckon the probable duration of pregnancy from a somewhat arbitrary date, that of the beginning or end of the last previous menstrual epoch. In the case of the domesticated animals greater accuracy is obtainable as to the time of coitus, and data are available as to the duration of pregnancy in both cattle and sheep. Regarding the latter Tessier’s observations deal with 912 ewes, and it appears that labour took place in these between the 146th and 157th days after impregnation, a very large majority of all the births taking place between the 149th and 153rd days. If the figures are reduced to a curve in which the births the ordinates and the dates the abscissse a fairly symmetrical figure is produced, in which the axis of the It seems probable curve corresponds with the 152nd day. that in the ewe only one ovum is shed at a time, and that some, at all events, of the variation in the actual date of the occurrence of labour is due to difference in the time taken by the spermatozoon to meet the ovum. It may be noted that as the 7’mtmMS ad fj11B1n is the actual birth, and the process of labour may be prolonged, another variable
form
1202 factor is introduced at the end of -the calculation. In the of blood during a temporary residence of some weeks at high case of cattle observations were recorded by the fifth Earl altitudes. The increased oxygen capacity is as regards one a of time from the half due to concentration of the blood and as to the other which show range extending Spencer, H20th to the 313th day after insemination, but as, according half to new formation of haemoglobin and red cells. In the to Dr. Hart, calves are to be regarded as premature before early days of the sojourn the whole change is due to diminuthe 260bh day, the period of variation is rather less than this. tion of the blood volume. The authors are not in agreeIf these figures are also reduced to a curve, again a ment with some of the conclusions of Douglas, Haldane, fairly symmetrical figure is produced, the maximum Henderson, and Schneider from their observations made on number of births lying between the 284th and 285th Pike’s Peak (3386 metres). When the St. Moritz rabbits days. It seems legitimate to conclude that, as might were brought back to Basel the blood volume reached the be predicted in a vital process, the duration of gesta- Basel normal in four days, and after the third day and tion is not a rigidly fixed period, while the greater onwards the daily fall in oxygen capacity ran parallel range of variation in cattle as compared with sheep to the fall in percentage haemoglobin. A formula is may be explained by assuming that in -the former two ova given for the calculation of the volume of blood in may be shed at intervals of three weeks, and that either one mammals, and the authors find the same formula applicable to certain birds which they name. This relation between or other may be fertilised at any particular act of coitus. blood volume and surface area of the body of mammals and as to the duration of human have been Figures pregnancy collected by several observers, notably by von Winckel and birds is related to the fact that they are homoiothermal by Reid, who calculated respectively from the first and last animals or animals of constant temperature. In poikilodays of the preceding menstrual period. Curves prepared thermal animals, such as a frog and lizard, the blood volume from their data again show fair symmetry, the range found is neither proportional to the body surface nor to the body by von Winckel being from the 258th to the 313th day, and weight. The blood volume increases as the animal grows bv Reid from the 252nd to the 316th. The maximum number heavier, while in warm-blooded animals there is a steady fell in the former author’s experience between the 282nd and diminution. Professor Dreyer and Dr. Ainley Walker also 289th days after the first day of the last menstruation ; in find that the ratio of the weight of the heart muscle-in that of the latter between the 276th and 279th day after the different species-to the total oxygen capacity is approximately cessation of the period. It is clear that we are not in a constant from species to species in a number of instances. position at present to predict with any accuracy the probable One of the other interesting results is the comparison of the duration of an individual pregnancy, and that further hare and wild rabbit to show the importance of life and observations are desirable. Dr. Hart suggests thatmore muscular activity as a factor in determining the amount and exact results might be obtained officially under the Insurance the distribution of the haemoglobin in the body. Animals Act " if the dates of beginning and end of the last period of with a high haemal haemoglobin have usually dark-coloured menstruation and the date of labour were recorded on the muscles and a high hmmoglobin percentage in their skeletal official cards which have to be prepared in order to establish muscles ; those with a lower haemal haemoglobin percentage have pale muscles. The hare as compared with the wild a claim to maternity benefit. rabbit has remarkable speed, greater endurance, higher ALTITUDE AND BLOOD VOLUME. haemoglobin percentage, darker muscles, a heavier heart, and a larger aorta. The hare has more than double the amount THE increase in the number of red blood corpuscles in of blood, 30 per cent. more haemal haemoglobin, and about animals and man living at high altitudes is a well-established three times as much heart muscle as a wild rabbit. These fact. Animals living in Mexico at 3700 metres have double and other facts recorded in this communication offer fruitful the normal number of red corpuscles, and Viault found for more extended investigation into the im6 to 9 millions per cubic millimetre in Peruvians dwelling suggestions of blood volume. at over 4000 metres. Miintz kept rabbits in the summit portant question of the Pic du Midi for seven years, and found thati AN INSTRUCTIVE MISTAKE. the iron percentage of the blood increased from 40’3 on ONE of the valuable features of the B1’itish Journal of the plain to 70’2milligrammes at the summit. There is also an increase in the haemoglobin percentage ’2crgeri is a series of cases published anonymously under the in the blood. These results have been ascribed to various heading of instructive Mistakes." In the following case causes. This week we print a communication on the a distended saccule of the bladder was mistaken for a caecal Effect of Altitude on Blood Volume by Professor G. Dreyer volvulus. A man, aged 79 years, in fair general health, who and Dr. E. W. Ainley Walker. From this it appears that had not suffered from any urinary symptoms, was seized there are also definite changes in the blood volume, which with abdominal pains and urgent vomiting, which was follow definite laws. Bohr observed that diving birds which copious and projectile. The pains were paroxysmal and remain several minutes under water have double as much referred to the lower abdomen, especially to the right iliac The authors have analysed the fossa, where a firm elastic swelling could be seen and felt. blood as ordinary birds. "almost inexhaustible wealth"of the information recorded During the pains it hardened palpably. It was only relaby Abderhalden from observations on rabbits kept at tively dull on percussion, and there was no obvious hypoSt. Moritz from four and a half to eight weeks, 1856 gastric fulness. The bowels had acted regularly, and after metres above sea level, in 1902, and they are led to enemata fasces and flatus ceased to be expelled. Purgatives the conclusion that the change of volume which occurs could not be retained on the stomach and therefore failed with a particular change of barometric pressure is pro- to act. The prostate was much enlarged, but there was no portional to the area of the body surface in different systitis. As urine was passed occasionally and instrumental individuals of a given species. The blood volume is ud did not appear to be required no catheter was passed. There diminished by an amount exactly proportional to their body was no general abdominal distension or tenderness. Volvulus surface. In the St. Moritz rabbits the diminution of blood- )f the csecal region was diagnosed and laparotomy was pervolume was nearly 11 per cent. ; the haemoglobin shows an formed, when the swelling was found to be a large distended increase and the number of red cells a parallel increase. The iaccule of a deformed bladder. The whole length of the increase of the haemoglobin reaches 11’ 7 per cent. of the total ntestines was examined methodically without finding any hsemoglobin. This shows that there is an active new formation )bstruction. An elbowed catheter was passed and the
,
eighteenth century took risks with their eyes open and with a lightness of heart, now only to be equalled among gipsies or proletarians. In 1777, for instance, the wife of a naval officer, afterwards one of Nelson’s admirals, CHILDBIRTH IN THE EIGHTEENTH CENTURY. narrowly escaped giving birth to her daughter in a theatre at where her versatile spouse was acting in the Duenna. ’IT can scarcely be disputed that the eighteenth centuryICork, He I had a passion for the stage as well as for war at sea. held semi-barbaric views as to the puerperal state and wifely « In the middle of the entertainment," according to duties in general. When, for instance, Csesarean section
obviously
should be
t the unpublished memoirs of the daughter in question, had to be resorted to, the mother was, when necessary, mother was taken ill, and escaped as quickly 66 may sacrificed in place of the child, whereas nowadays the " as possible and got home only a few doors distant, mother, as a possible producer of further offspring, is spared i but no one was in to open the door. My father, guessing and the child is sacrificed. The theory of the old medical ran. home in all what had his disguise and occurr’d, jurisprudence was that everything should be done to safe- broke the door before the servant 1 could be awoke open guard the life of an heir; and a mother, as not being an heir, from a fit into she had which fallen fainting by reason was as often as not the victim of her infant’s claims to a " How our ancestors were born, and how the heat." of succession. She was the slave of testamentary dispositions, and at times was compelled by these to give birth to her they died, would form a fascinating volume, but from various motives, are always baby at some stated place. Often, again, during preg- mourners and survivors, reticent as to these desirable data. Even in the case of nancy she was made to suffer bitterly in the cause famous men the cause of death is rarely mentioned. medical of dynastic or family feuds ; and often, when no feud existed, she was bandied about during the period We know that John Hunter died from heart disease, but what of gestation in a manner horrifying to modern notions did the great Joseph Henry Green die from when, like some of decency. It speaks volumes for our ancestresses that hero of antiquity, he said Stopped!"after his pulse had they apparently acquiesced with much cheerfulness in actually ceased to beat ? If these deaths of famous men be A historic document was issued in obscure, how much more impenetrable are the circumstances these arrangements. of their births. ambassadors in 1737 II. to all
by George
,
foreign
England
and to all British ambassadors abroad. Republished for the benefit of the public, it appears as the very scarce pamphlet entitled Letters and Messages, that passed between the King, Queen, Prince, and Princess of Wales ; on occasion of the Birth of the Young Princess." It was sold to a generation in sympathy with Frederick, Prince of Wales, for the sum of 6d., and presents a perfect picture of our ancestors’ attitude towards a mother in posse. Late in July, 1737, the Princess of Wales, wife of the notorious, but not very wicked, Prince Frederick, had been to all appearances seized with labour pains and had been hurried at dead of night from Hampton Court to St. James’s in order that she might become a mother in London. The roads were rough, footpads swarmed in the neighbourhood of what is now the Albert Memorial, the carriages even of the great hung on uneasy springs and ran on heavy iron tyres. Yet despite all this, Prince Frederick endangered his consort’s life in order probably that the child might be born away from the Court and that the witty Queen Caroline might not be present at its birth. The supposition is that of Lord Hervey, whose fascinating memoirs have been so often quoted by Leigh Hunt in his description of the goings on at Kensington Palace when Queen Caroline resided there ("The Old Court Suburb"). On arrival at St. James’s the beds were found to be unaired, and the only lady in attendance was a reputed mistress of the Prince. The pains, however, abated, and a return was made to Hampton Court. This happened on a Monday night or on a Tuesday morning. On the Friday following the pains returned, and again the Princess was rattled to St. James’s, only to return to Hampton Court on a Saturday. On Sunday, however, there could be no doubt about her condition. She was got to London and gave birth to a princess, sister of the future George III. The Prince, writing in the curious Court French of the time, avers that there was no midwife at Hampton Court, and that neither Doctors
____
THE
PERIOD OF GESTATION.
THE determination of the normal period of gestation is a natter of considerable practical importance, but up to the present time no very definite knowledge can be said to exist The problem is discussed by Dr. D. Berry 3n this point. Hart in the current number of the Edinburg7t Medical J01lrnal. An obvious difficulty is encountered at the outset of any inquiry on the subject in that the terminqts a quothe moment when the ovum is fertilised by the spermatozoon -cannot be accurately recognised, for it is almost certain that the male element may remain alive in the female passage for some days, while it is exceptional in the case of human beings to be able to trace a pregnancy to a single act of insemination on a known date. Hence it is necessary in the case of mankind to reckon the probable duration of pregnancy from a somewhat arbitrary date, that of the beginning or end of the last previous menstrual epoch. In the case of the domesticated animals greater accuracy is obtainable as to the time of coitus, and data are available as to the duration of pregnancy in both cattle and sheep. Regarding the latter Tessier’s observations deal with 912 ewes, and it appears that labour took place in these between the 146th and 157th days after impregnation, a very large majority of all the births taking place between the 149th and 153rd days. If the figures are reduced to a curve in which the births the ordinates and the dates the abscissse a fairly symmetrical figure is produced, in which the axis of the It seems probable curve corresponds with the 152nd day. that in the ewe only one ovum is shed at a time, and that some, at all events, of the variation in the actual date of the occurrence of labour is due to difference in the time taken by the spermatozoon to meet the ovum. It may be noted that as the 7’mtmMS ad fj11B1n is the actual birth, and the process of labour may be prolonged, another variable
form
1202 factor is introduced at the end of -the calculation. In the of blood during a temporary residence of some weeks at high case of cattle observations were recorded by the fifth Earl altitudes. The increased oxygen capacity is as regards one a of time from the half due to concentration of the blood and as to the other which show range extending Spencer, H20th to the 313th day after insemination, but as, according half to new formation of haemoglobin and red cells. In the to Dr. Hart, calves are to be regarded as premature before early days of the sojourn the whole change is due to diminuthe 260bh day, the period of variation is rather less than this. tion of the blood volume. The authors are not in agreeIf these figures are also reduced to a curve, again a ment with some of the conclusions of Douglas, Haldane, fairly symmetrical figure is produced, the maximum Henderson, and Schneider from their observations made on number of births lying between the 284th and 285th Pike’s Peak (3386 metres). When the St. Moritz rabbits days. It seems legitimate to conclude that, as might were brought back to Basel the blood volume reached the be predicted in a vital process, the duration of gesta- Basel normal in four days, and after the third day and tion is not a rigidly fixed period, while the greater onwards the daily fall in oxygen capacity ran parallel range of variation in cattle as compared with sheep to the fall in percentage haemoglobin. A formula is may be explained by assuming that in -the former two ova given for the calculation of the volume of blood in may be shed at intervals of three weeks, and that either one mammals, and the authors find the same formula applicable to certain birds which they name. This relation between or other may be fertilised at any particular act of coitus. blood volume and surface area of the body of mammals and as to the duration of human have been Figures pregnancy collected by several observers, notably by von Winckel and birds is related to the fact that they are homoiothermal by Reid, who calculated respectively from the first and last animals or animals of constant temperature. In poikilodays of the preceding menstrual period. Curves prepared thermal animals, such as a frog and lizard, the blood volume from their data again show fair symmetry, the range found is neither proportional to the body surface nor to the body by von Winckel being from the 258th to the 313th day, and weight. The blood volume increases as the animal grows bv Reid from the 252nd to the 316th. The maximum number heavier, while in warm-blooded animals there is a steady fell in the former author’s experience between the 282nd and diminution. Professor Dreyer and Dr. Ainley Walker also 289th days after the first day of the last menstruation ; in find that the ratio of the weight of the heart muscle-in that of the latter between the 276th and 279th day after the different species-to the total oxygen capacity is approximately cessation of the period. It is clear that we are not in a constant from species to species in a number of instances. position at present to predict with any accuracy the probable One of the other interesting results is the comparison of the duration of an individual pregnancy, and that further hare and wild rabbit to show the importance of life and observations are desirable. Dr. Hart suggests thatmore muscular activity as a factor in determining the amount and exact results might be obtained officially under the Insurance the distribution of the haemoglobin in the body. Animals Act " if the dates of beginning and end of the last period of with a high haemal haemoglobin have usually dark-coloured menstruation and the date of labour were recorded on the muscles and a high hmmoglobin percentage in their skeletal official cards which have to be prepared in order to establish muscles ; those with a lower haemal haemoglobin percentage have pale muscles. The hare as compared with the wild a claim to maternity benefit. rabbit has remarkable speed, greater endurance, higher ALTITUDE AND BLOOD VOLUME. haemoglobin percentage, darker muscles, a heavier heart, and a larger aorta. The hare has more than double the amount THE increase in the number of red blood corpuscles in of blood, 30 per cent. more haemal haemoglobin, and about animals and man living at high altitudes is a well-established three times as much heart muscle as a wild rabbit. These fact. Animals living in Mexico at 3700 metres have double and other facts recorded in this communication offer fruitful the normal number of red corpuscles, and Viault found for more extended investigation into the im6 to 9 millions per cubic millimetre in Peruvians dwelling suggestions of blood volume. at over 4000 metres. Miintz kept rabbits in the summit portant question of the Pic du Midi for seven years, and found thati AN INSTRUCTIVE MISTAKE. the iron percentage of the blood increased from 40’3 on ONE of the valuable features of the B1’itish Journal of the plain to 70’2milligrammes at the summit. There is also an increase in the haemoglobin percentage ’2crgeri is a series of cases published anonymously under the in the blood. These results have been ascribed to various heading of instructive Mistakes." In the following case causes. This week we print a communication on the a distended saccule of the bladder was mistaken for a caecal Effect of Altitude on Blood Volume by Professor G. Dreyer volvulus. A man, aged 79 years, in fair general health, who and Dr. E. W. Ainley Walker. From this it appears that had not suffered from any urinary symptoms, was seized there are also definite changes in the blood volume, which with abdominal pains and urgent vomiting, which was follow definite laws. Bohr observed that diving birds which copious and projectile. The pains were paroxysmal and remain several minutes under water have double as much referred to the lower abdomen, especially to the right iliac The authors have analysed the fossa, where a firm elastic swelling could be seen and felt. blood as ordinary birds. "almost inexhaustible wealth"of the information recorded During the pains it hardened palpably. It was only relaby Abderhalden from observations on rabbits kept at tively dull on percussion, and there was no obvious hypoSt. Moritz from four and a half to eight weeks, 1856 gastric fulness. The bowels had acted regularly, and after metres above sea level, in 1902, and they are led to enemata fasces and flatus ceased to be expelled. Purgatives the conclusion that the change of volume which occurs could not be retained on the stomach and therefore failed with a particular change of barometric pressure is pro- to act. The prostate was much enlarged, but there was no portional to the area of the body surface in different systitis. As urine was passed occasionally and instrumental individuals of a given species. The blood volume is ud did not appear to be required no catheter was passed. There diminished by an amount exactly proportional to their body was no general abdominal distension or tenderness. Volvulus surface. In the St. Moritz rabbits the diminution of blood- )f the csecal region was diagnosed and laparotomy was pervolume was nearly 11 per cent. ; the haemoglobin shows an formed, when the swelling was found to be a large distended increase and the number of red cells a parallel increase. The iaccule of a deformed bladder. The whole length of the increase of the haemoglobin reaches 11’ 7 per cent. of the total ntestines was examined methodically without finding any hsemoglobin. This shows that there is an active new formation )bstruction. An elbowed catheter was passed and the
,