proven. Simon experimented with white mice, puppies, and guinea-pigs, not using cultures, but seeking to follow the progress of the micro-organism from mother to

fœtus with the microscope. In studying puppies, the uterus of the mother was imbedded, cut in sections, and each section studied. In the membranes, including that which contained the amniotic fluid and the funis, bacilli were found in great numbers, having apparently reached that location by way of the placenta. The foetus had bacilli upon its surface and in the tissues of the abdominal wall. Infection of the foetus in general was not frequent, perhaps because the conditions of the foetal blood were unfavorable to the life conditions of the bacilli. Three stages of the disease process in anthrax were clearly observed. When it had lasted the ordinary period of time, the maternal portion of the placenta was found abundantly supplied with bacilli, and so were the membranes, amniotic fluid, and superficial portion of the fœtus. If the disease were of longer duration there were bacilli in the foetus. Other questions which were of importance in this study were the greater or lesser resistance of the maternal compared with the foetal tissue, the virulence of the infecting poison, the condition and disposition of the leucocytes, etc.

DISEASES OF THE SKIN.

Pemphigus. Of the diseases of

the skin which appear as epidemics

PESE

Na
ance

Mors

5

DOCTEUR

SUTILS

KO

ཐ ་ ལ འ ག་

BALLANTYNE INFANT-WEIGHER. (Edinburgh Medical Journal.)

among the newly born, pemphigus may be mentioned, such epidemics having been observed in 1870 by Olshausen, in 1872

by Ahlfeld, in 1873 by Moldenhauer, and in the past year by Almquist, at Göteborg, 134 cases being seen in the course of three and a half months. The vesicles developed rapidly upon. the thighs, abdomen, neck, and head. The fluid was first clear serum, then pus, and finally a crust was formed. None of the cases were fatal, neither was there coincident ophthalmia in the children nor puerperal disease in the mothers. The organism in the fluid was a diplococcus, which resembled the staphylococcus pyogenes aureus, but the results were not such as are produced by that microbe. The disease was probably transmitted by midwives. Such epidemics emphasize the importance of cleanliness on the part of the attendants and the surroundings of infants.

366

Vaccination.-Wolff, after carefully vaccinating a large number of newborn infants and watching the results, found that inoculation usually resulted without very great constitutional disturbance. Inasmuch as many of the fatal cases of small-pox occur during the first three months of life, it would seem to him desirable that all newborn infants should be vaccinated with fresh calflymph, excepting those who are premature or enfeebled by disease. He did not think that vaccination tended to bring out a latent syphilis, as has been asserted by some writers.

118

Mar.

Erysipelas.-Morel studied 5 cases of erysipelas in the newborn, 4 of them being fatal on the second or third day. In the blood from the heart there were a few streptococci. The serum of the blood taken from the vicinity of the diseased tissues contained streptococci in abundance. The lesions in this disease are nearly the same as in adults, the skin and the subcutaneous layer being almost normal. There were no wandering cells and no swelling of the fixed cells.

WRYNECK.

This condition in the newborn is not infrequent. Very excellent observers, including Dieffenbach, Stromeyer, and, more recently, Ruge, have considered it as of traumatic origin, or as proceeding from violence during parturition. It would seem to be, primarily at least, an induration of the sterno-mastoid muscle, without inflammatory elements; hence Quisling's term, myositis sterno-cleido-mastoidea, 158 is apt to be misleading, unless a given case is watched very closely for symptoms of inflammation. Quis

51

Oct.

ling has reported 3 cases during the past year. Parker 5 has reported 2 cases. The first was a female delivered with forceps applied to the after-coming head, the presentation being dorsoanterior breech. The induration of the sterno-mastoid muscle (on the left side) was not observed until the twenty-sixth day, and it yielded to gentle friction after a few weeks. The second case was also one in which there had been a breech presentation, with forcible extraction. The induration appeared on the right side on the twentieth day, and disappeared after six weeks. Parker thinks that force enough was used in both cases to tear more or fewer of the fibres of the sterno-mastoid, and thus cause inflammatory effusion with subsequent cicatricial contraction. I cannot agree with him. If there were inflammation, it is in the highest degree improbable that the children would have shown no evidence of it during the three weeks before the induration appeared. If there were effusion into or around the sheath of the muscle, why should it not have manifested itself very quickly by pain, swelling, and distortion of the head? The conclusions of Peterson upon this subject, which seem to us more probable and credible, are as follow: 1. There is no authentic instance in literature of the occurrence of wryneck from the rupture of muscular tissue during parturition. 2. Clinical experience and negative results from experiments on animals show that wryneck does not come from the rupture of muscular tissue. 3. Shortening of structure, which produces wryneck, may occur during foetal life. 4. Continued contact of the points of origin and attachments of a growing muscle will cause shortening of that muscle. 5. The intra-uterine origin, the frequent occurring of this condition on the right side, in connection with breech-presentations and difficult labors, show that it is due to an abnormal condition of the amnion. 6. Stromeyer's teaching, that it is of traumatic origin, is no longer tenable. 7. Congenital wryneck is never due to fault on the part of the accoucheur or the midwife.

THE NAVEL.

999

B.1,H.1

The importance of this structure in the newborn can hardly be overestimated. Its well-being is vital to the condition of the child, and investigators have not been backward in increasing the attention with which it has long been regarded, as bacteriology intensifies its importance as a mode of ingress for various harmful