dead fetus
in left occipito-anterior presentation, very high in the inlet. The os
was nearly completely dilated, the pains strong. By 4 P.M. the head was
hardly engaged in the pelvic cavity. At 7 P.M. it neared the outlet at
the height of each pain, but retracted immediately afterward. After 10
P.M. the pains grew weak. At midnight Wygodzky delivered the dead child
by expression. Not till then was the cause of delay clear. The funis
was very tense and coiled 7 times round the neck and once round the
left shoulder; there was also a distinct knot. It measured over 65
inches in length. The fetus was a male, slightly macerated. It weighed
over 5 pounds, and was easily delivered entire after division and
unwinding of the funis. No marks remained on the neck. The placenta
followed ten minutes later and, so far as naked-eye experience
indicated, seemed healthy.

Intrauterine fractures are occasionally seen, but are generally the
results of traumatism or of some extraordinary muscular efforts on the
part of the mother. A blow on the abdomen or a fall may cause them. The
most interesting cases are those in which the fractures are multiple
and the causes unknown. Spontaneous fetal fractures have been
discussed thoroughly, and the reader is referred to any responsible
text-book for the theories of causation. Atkinson, De Luna, and Keller
report intrauterine fractures of the clavicle. Filippi contributes an
extensive paper on the medicolegal aspect of a case of intrauterine
fracture of the os cranium. Braun of Vienna reports a case of
intrauterine fracture of the humerus and femur. Rodrigue describes a
case of fracture and dislocation of the humerus of a fetus in utero.
Gaultier reports an instance of fracture of both femora intrauterine.
Stanley, Vanderveer, and Young cite instances of intrauterine fracture
of the thigh; in the case of Stanley the fracture occurred during the
last week of gestation, and there was rapid union of the fragments
during lactation. Danyau, Proudfoot, and Smith mention intrauterine
fracture of the tibia; in Proudfoot's case there was congenital talipes
talus.

Dolbeau describes an instance in which multiple fractures were found in
a fetus, some of which were evidently postpartum, while others were
assuredly antepartum. Hirschfeld describes a fetus showing congenital
multiple fractures. Gross speaks of a wonderful case of Chaupier in
which no less than 113 fractures were discovered in a child at bir