Monstrosity: Fœtus in Fœtu

Abstract

On the afternoon of the 7th of November, 1854, I was called to see Mrs. J. IL, who had been suffering the pangs of maternity about four hours. She had previously borne six children, and in but one or at most two instances had the time of labor exceeded that which had elapsed in the present effort. The pains were markedly inefficient and distressing; both on this account and by reason of her unusually increased size, coupled with the fact that quickening had never been very decided and the foetal movements always very feeble, she was exceedingly anxious. About two hours subsequent to my arrival, and when for a little time the paroxysms of pain had been less marked, I was suddenly startled by a violent scream from the patient, and a great gush of water, which latter an immediate examination proved to be the result of ruptured membranes. The outcry seemed not so much induced by increased pain as from shock consequent upon the sudden and excessively abundant discharge of liquor amiiii.Pushing my investigations with the purpose of determining the position of the child, I found protruding from the os a ragged mass of so little consistency as to lead to the supposition that it was a partially detached placenta, but the absence of haemorrhage soon convinced me that such was not the case. To satisfy myself at this time concerning it was simply impossible, with the light of my reading or experience.Fortunately the pains forthwith became more characteristic of true labor, though still ineffectual in promoting progress, and as nothing but the anomalous mass presenting and the difficulty in defining the position of the child afforded special cause of anxiety or pretext for interference, it was thought best to await natural developments.The patient seemed very feeble, and so excessively nervous that convulsions were at times seriously apprehended. Whisky punch and quinine were freely administered, with the result of allaying nervous symptoms and of inducing labor pains more decided in character. Examinations were still very unsatisfactory, as I could find nothing by which to identify the presentation. Thus obscurely the labor proceeded The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org at BOSTON UNIVERSITY on June 25, 2016. For personal use only. No other uses without permission. From the NEJM Archive.