1902 Encyclopedia > Abnormal Development & Congenital Malformations > Reversed Position of the Viscera

Abnormal Development and Congenital Malformations
(Part 11)

(11) Reversed Position of the Viscera

This is a developmental error depending on the retention of the right aortic arch as in birds, instead of the left as is usual in mammals. The position of all the unsymmetrical viscera is transposed, the spleen and cardiac end of the stomach going to the right side, the liver to the left, the caecum resting on the left iliac fossa, and the sigmoid flexure of the colon being attached to the right. This condition of situs inversus riscerum need cause no inconvenience; and it will probably remain undetected until the occasion should arise for a physical diagnosis or post-mortem inspection.

There are numerous other anomalies in the development of the great vessels. In the heart itself there may be an imperfect septum ventriculorum, and there is more frequently a patency of the foetal communication between the auricles, permitting the venous blood to pass into the arterial system, and producing the livid appearance of the face known as cyanosis.

The causes of congenital anomalies are difficult to specify. There is no doubt that, in some cases, they are present in the sperm or germ of the parent; the same anomalies recur in several children of a family and it has been found possible, through a variation of the circumstances, to trace the influence in some cases to the father alone, and in other cases to the mother alone.

The remarkable thing in this parental influence is that the malformation in the child may not have been manifested in the body of either parent, or in the grandparents. More often the malformation is acquired by the embryo and foetus in the course of development and growth, either through the mother or in itself independency.

Maternal impressions during pregnancy have often been alleged as a cause, and this causation has been discussed at great length by the best authorities. The general opinion seems to be that it is impossible to set aside the influence of subjective states of the mother altogether. The doctrine of maternal impressions has often been resorted to when any other explanation was either difficult or inconvenient; thus, Hippocrates is said to have saved the virtue of a woman who gave birth to a black by pointing out that there was a picture of a Negro on the wall of her chamber.

Injuries to the mother during pregnancy have been unquestionably the cause of certain malformations, especially of congenital hydrocephalus. The embryo itself and its membranes may become the subject of inflammations, atrophies, hypertrophies, and the like; the causation, to which Otto traced all malformations of the foetus, is doubtless accountable for a good many of them.

But a very large residue of, malformations must still be referred to no more definite cause than the erratic spontaneity of the embryonic cells and cell-groups. The nisus formativus of the fertilized ovum is always made subject to morphological laws, but, just as in extra-uterine life, there may be deviations from the beaten track; and even a slight deviation at an early stage will carry with it far-reaching consequences. This is particularly noticeable is double monsters.

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