than in adult. The ordinary jaundice of the newborn infant is due to the superabundance of red blood-corpuscles which are destroyed in the liver, giving rise to an excess of bile pigment. It is reasonable to suppose that it is also hematogenic, the destruction of the red blood-corpuscles setting free hæmoglobin in the blood. The foetal blood contains a large amount of hæmoglobin. At birth there is 120.2 per cent. compared with 93.8 per cent. in mother, and this increases for 36 to 48 hours, then diminishes. Liver. Blood supply diminished, capillaries less distended, secretion of bile lessened. Lower pressure in hepatic veins. Capsule of Glisson swollen, associated with exfoliation of the cord. Heart. Exhibits transition from foetal to infantile circulation by closure of foramen ovale and obliteration of ductus arteriosus. Cord. Necrosis of After 24 hours, line of demarcation at its base. amniotic covering. Mummification of mucous tissue. Destruction of its vessels. Cord drops off about 4th day, followed by retraction of granulating button within the umbilical ring. Medico-Legal Points. It is impossible to definitely determine whether child has lived and whether injuries on its body have been inflicted with murderous intent. Discoloration about the neck points strongly to strangulation. Anatomical Points. To be borne in mind when making autopsies to determine cause of death of newborn infant. The normal relatively large size of thymus gland and heart. An enlarged thymus may completely close the trachea. Lungs should be inflated and overlap heart. Liver, of body weight. Ductus choledochus should be patulous. The sigmoid and appen dix very large and the bladder relatively large. Examine hypo gastric arteries for septic infection. To facilitate an examina- Abnormalities in the Physiology of Premature Infants. (a) Low temperature-variations below 980. Treatment.—Incubation and gavage. In the absence of the most approved incubator, such as Tarnier's, one can be readily improvised with an ordinary baby bath tub, several layers of cotton-wool, and a number of beer bottles filled with hot water. Gavage is the regular feeding of the infant with freshly-drawn mother's milk through a small soft catheter passed into the stomach at each feeding. Mortality of this Treatment:- At 6 months 22 per cent. saved. 66 7 66 38 "68 66 89 Sclerema. A disease only found in these premature infants. Occurs most often in lying-in hospitals. The most prominent symptom is a hardening of the skin, beginning in the legs and spreading, usually sparing breasts and belly. Jaundice or a hemorrhagic condition usually accompanies it. Temperature is very low, 950. Its pathology is not well understood. The most probable explanation is that the large excess of palmitic acid in infants solidifies at this low temperature. The condition is a grave one and apt to be fatal. Management of Newborn Infant. Clothing. A baby should be clothed in winter as follows: A binder, of flannel or knit wool, twice around abdomen, a knit shirt, diaper, knit shoes, and two skirts, the first flannel (in midsummer, linen), and finally its dress. The skirts should be supported from the o- allows regurgitation when the slow-ach is the full 90°F 85°F e in other words do nur let the child perspins freeing. Profel food wi ing into take through fun el, by плосий вит drafter or by glow-rezsunge Iroffer is hest. Milk is droped drop by. trap into mouth and lady + This well swallonge may seens buller their the regularдивеч |