Monstrous births and medical networks: debates over forensic evidence, generation theory, and obstetrical authority in France, ca. 1780-1815.

In France between 1780 and 1815, doctors opened a broad correspondence with medical faculties and public officials about foetal anomalies ("monstrosities"). Institutional and legal reforms forced doctors to encounter monstrous births with greater frequency, and they responded by developing new ideas about heredity and embryology to explain malformations to public officials. Though doctors achieved consensus on pathogenesis, they struggled to apply these ideas in forensic cases, especially with doubtful sex. Medical networks simultaneously allowed doctors to explore obstetrical techniques, as licensing regulations forced practitioners into emotional encounters with child anomalies. Doctors thus developed a new ethics for treating monstrosities, viewing them as pathological specimens, forensic objects, and obstetrical tragedies.

[Fetus in fetu and acardiac monster: can the similar patterns of these 2 malformations be explained by a common morphogenic mechanism?]. / Foetus in fetu et monstre acardiaque: un mécanisme morphogénique commun explique-t-il les similitudes de ces deux malformations?

Fetus in fetu and acardiac monster are two unusual malformations (estimated incidences: 1 in 500,000 and 1 in 34,600 deliveries respectively) which present very similar morphological patterns. The authors report two cases of acardiac monster and a case of fetus in fetu which emphasize this fact. These findings suggest that a single morphogenic mechanism leads to the defects observed in these two groups of malformations.

Cranioschisis aperta with encephaloschisis in cephalothoracopagus hamster twins.

The results of gross and histopathological study of a near-term male hamster exencephalic lateral cephalothoracopagus are presented. There was minimal duplication of the internal organs to the point of division at the abdomen. The appendicular skeleton was relatively unaffected by the severe malformations of the axial skeleton. The studies suggested that the lateral relationship of the skull to the spinal columns was a consequence of the presence of two embryonic neural tubes; the chordomesodermal systems of the right and left twins apparently contributed the tissues for the right and left cephalic neural folds, respectively. Anomalies of the vertebral bodies and neural arches were not related to failure of closure of the neural tube as there was no evidence for rachischisis in either body half. Rather, the anomalous axial skeletal elements were apparently the result of competing fields of development by two chordomesodermal systems. The twins were recovered from a dam maintained on a diet consisting of 80% cassava, a cyanide-containing staple consumed by humans in tropical countries. Because the numbers of resorbed implantation sites and malformed litermates were low and the failure to produce conjoined twins in other litters recovered from dams given cassava diets, it appears unlikely that the malformation was related to the composition of the diet.

[Opocephalic triocephalus in a calf]. / Opocephale Triocephalie beim Kalb.

This describes the malformation in the skull of a newborn calf. The facial bones are missing, the ears seem to be placed at the upper end of the neck. One single eye is placed on a pillar in the middle, which is about five centimeters long, protruding forward; the mouth, which has the shape of an anus-like opening, is beneath the eye.

Etiological aspects of double monsters.

Four cases of double monsters are reported, including a rare case of craniofacial duplication (diprosopus). Based on the findings observed, etiological factors of these malformations are discussed. We suggest that exogenous (environmental) factors such as habits, way of life or religious practices of certain populations can influence the development of double monsters.

Amniochorionic bands and adhesions with fetal deformities.

The amniochorionic bands and adhesions in 2 malformed human fetuses are described. The anencephaly, left harelip with grossly distorted face, and rudimentary right upper limb of case 1, and multiple pits and cavities in the liver of case 2, are directly attributable to membranous adhesions. The toughness of the bands is indicative of their mesoblastic (chorionic) origin. The histolytic effect on the liver of case 2 may suggest a contact with the trophoblastic cells. The exomphalos of case 1, and extroversion of cloaca with other caudal defects of case 2, are possibly due to vascular and mesodermal deficits imposed by single umbilical artery.

A note on the epidemiology of acardiac monsters.

The literature on acardiac monsters has been reviewed. The following conclusions were drawn: 1. The probability of their appearance seems considerably higher among monoamniotic than diamniotic monochorionic twin pairs. 2. They seem more likely to occur within monozygotic (MZ) pairs in higher multiple births than in MZ twins. 3. The data are consistent with the suggestion that there is a slight female excess among them.

Cyclopian monster with anophthalmos.

A cyclopian monster with anophthalmos is a rare occurrence. Such a case is presented along with a case of a cyclops with synophthalmos. The many abnormalities result from an anomalous development of structures derived from the prosencephalon.

Epidemic of conjoined twins in Southern Africa?

Eleven sets of conjoined twins have been born in Southern Africa in a period of just over twelve months. Analysis of the circumstance pertaining to the conception and delivery of these children revealed considerable ethnic, geographic, and socioeconomic differences. It is possible that a ubiquitous environmental agent is a precipitating factor in this situation.