From these and other peculiarities it will be seen that the foetal
circulation differs essentially from that of a child after birth; and, in
order to comprehend the nature and mechanism of the changes which take
place in it when respiration first commences, it will be necessary that
these peculiarities should be thoroughly understood. The condition of the
foetus must also be remembered: surrounded by the liquor amnii, the foetus
does not respire; its lungs have as yet been unemployed; they are
therefore small and collapsed, and present a firm solid mass, nearly
resembling liver in appearance. In this state but little blood from the
pulmonary arteries can circulate through them; for, as the extreme
ramifications of these vessels are distributed upon the mucous membrane
lining the bronchi and air-cells, the free passage of blood through them
will in great measure depend upon a previous condition of the air-cells.
The pulmonary arteries in the foetal state are therefore small, and
transmit but a small quantity of blood into their numerous ramifications,
just sufficient to keep pervious these vessels which after birth are to be
so greatly distended: in this state the lungs when thrown into water sink.
Hence, as the pulmonary arteries do not afford a sufficiently free exit to
the contents of the right side of the foetal heart, nature has provided it
with a peculiar means for carrying off the overplus quantity of blood,
which is poured into the right auricle from the vena cava. This is
attained first by the _foramen ovale_, an oval-shaped opening in the
septum between the right and left auricles, and furnished with a semilunar
valvular flap, so constructed, as to allow a free passage for the blood
from the right to the left auricle, but none in the contrary direction. By
this means a considerable quantity of blood is transmitted at once from
the right to the left auricle, and, consequently, much less into the right
ventricle and pulmonary artery. Still, however, more blood passes into the
right ventricle than the pulmonary artery, in the collapsed state of the
foetal lungs, is capable of conveying away. The pulmonary artery is
therefore continued beyond its bifurcation into the aorta at its
curvature, by means of the _ductus arteriosus_, which, in the full-grown
foetus, forms a short thick passage between these two vessels; and in this
manner is the right ventricle enabled to get rid of its surplus quantity
of blood. Thus we see that the foetal heart although consisting of two
auricles and two ventricles, continues to perform the functions only of a
single heart, both ventricles assisting simultaneously to propel the same
column of blood, viz. that of the aorta, and thus enabling the heart to
act with considerable power.
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