The Ethics of Medical Homicide and MutilationO'Malley, Austin
Religion
The Ethics of Medical Homicide and Mutilation
O'Malley, Austin
Medical ethics
Any of the acute infections, as typhoid, typhus, smallpox, measles,
scarlatina, and the others, attacks a pregnant woman as readily
as one who is not pregnant. Pregnancy, as a rule, lessens the
resistance to the infection, and the infection is likely to cause
abortion. The toxin of the infection is added to the physiological
toxins of pregnancy, the kidneys often are overwhelmed, and there
is a tendency to hemorrhage. After the exhaustion from the disease,
delivery, whether premature or at term, is liable to end in collapse,
especially if the heart or lungs have been injured. Puerperal sepsis,
either general or local, is a common effect of these bacterial
diseases. In smallpox there is infection from the pustules and the
virus itself; in typhoid the typhoid bacillus and the streptococci
in Peyer's patches get into the blood; in influenza, pneumonia,
erysipelas, and diphtheria the bacteria directly cause sepsis, and in
scarlatina the pus organisms from the throat are found in the septic
foci.
In these infections the fetus may be killed by the high temperature;
it may die from asphyxia brought on by feeble maternal blood-pressure
and consequent stagnation of the circulation in the uterine sinuses;
it may be overwhelmed by maternal hemorrhage; by deoxidation of the
maternal blood, as in pneumonia; by a hemorrhage in the placenta, and
a consequent separation of the placenta itself from the uterine wall;
by fatty degeneration of the fetal villi, which renders respiration
of gases impossible. Again, the child may be infected by the disease
of the mother, or it may be killed by the toxins in the maternal
circulation.
The communication between the fetal and the maternal blood systems
is as indirect as that between the air in a man's lungs and his
blood. The communication between mother and fetus is by osmosis, but
certain toxins, drugs, and bacteria may also pass from the maternal
to the fetal circulation through the placenta. Strychnia injected
directly into the embryos of animals by Savory and Gussarow killed
the mother after passing to her through the placenta. There is no
direct communication (except by osmosis) between the fetal chorionic
villi and the maternal intervillous blood spaces. In the first half
of pregnancy fetal and maternal blood are separated by the syncytium,
Langhan's layer of cells, the stroma of the villi, and the walls of
the fetal capillaries; in the second half of gestation Langhan's
layer gradually disappears. In the fetal blood-vessels are found
many nucleated red corpuscles, but these are lacking in the maternal
intervillous spaces. Sänger also discovered that in pernicious
leucemia the leucocytes of the mother are not present in the fetal
circulation.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account