The so-called _Maternal Impression_ is looked on, especially by the laity, as another common cause of these deformities. Medical men will usually receive histories of such with a smile of incredulity, and rightly so; but some recorded cases, if true, are so definite that to condemn such an explanation too dogmatically seems scarcely to indicate a scientific spirit. The usual type of history given is that _after_ the mother has seen the defect in the newly-born infant, she looks back over the preceding nine months to see if there were any apparent cause for the trouble, and seeking out particularly some shock or fright produced by seeing something resembling the defect in her infant often selects something trivial and irrelevant. The following authentic case is worthy of mention:[33] A child was born deformed by a left unilateral harelip. The mother immediately asked to see the infant, declaring she was afraid it was marked, and on seeing it manifested no surprise at the appearance of its lip, stating that when about four months pregnant she received a fright, from the shock of which she had not yet fully recovered. Startled by a boy running almost into her arms, from whose face blood was streaming, she had seen a cut in the left side of the upper lip, extending through its substance into the nostril, laying bare the gums and teeth. She turned faint with fright, and could not banish the thought even after reaching home. The lad was subsequently examined, and the scar of a cut was found in that position. In spite of such facts, however, one hesitates somewhat in accepting the antecedent alarm and the subsequent deformity in the relationship of cause and effect. The imaginary “maternal impression” probably in nine cases out of ten has nothing to do with the defect; whilst a real “maternal shock” which possibly led to the production of the deformity passes unnoticed. Mr. Carless tells me of a case recently seen by him of a cleft of the soft palate in a child, whose mother, without asking any leading questions, gave a history of a sharp attack of febrile disturbance keeping her in bed two or three weeks at a period when the fœtus could not have been more than two months old. This is the type of maternal shock we should possibly look for, rather than the more out-of-the-way maternal impressions commonly suggested.