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There are many accounts of new-born infants who were characterized by their diminutive size. On page 66 we have mentioned Usher's instance of twins born at the one hundred and thirty-ninth day weighing each less than 11 ounces; Barker's case of a female child at the one hundred and fifty-eighth day weighing 1 pound; Newinton's case of twins at the fifth month, one weighing 1 pound and the other 1 pound 3 1/2 ounces; and on page 67 is an account of Eikam's five-months' child, weighing 8 ounces. Of full-term children Sir Everard Home, in his Croonian Oration in 1824, speaks of one borne by a woman who was traveling with the baggage of the Duke of Wellington's army. At her fourth month of pregnancy this woman was attacked and bitten by a monkey, but she went to term, and a living child was delivered which weighed but a pound and was between 7 and 8 inches long. It was brought to England and died at the age of nine, when 22 inches high. Baker mentions a child fifty days' old that weighed 1 pound 13 ounces and was 14 inches long. Mursick describes a living child who at birth weighed but 1 3/4 pounds. In June, 1896, a baby weighing 1 3/4 pounds was born at the Samaritan Hospital, Philadelphia.

Scott has recorded the birth of a child weighing 2 1/2 pounds, and another 3 1/4 pounds. In the Chicago Inter-Ocean there is a letter dated June 20, 1874, which says that Mrs. J. B. McCrum of Kalamazoo, Michigan, gave birth to a boy and girl that could be held in the palm of the hand of the nurse. Their aggregate weight was 3 pounds 4 ounces, one weighing 1 pound 8 ounces, the other 1 pound 12 ounces. They were less than 8 inches long and perfectly formed; they were not only alive but extremely vivacious.

There is an account of female twins born in 1858 before term. One weighed 22 1/2 ounces, and over its arm, forearm, and hand one could easily pass a wedding-ring. The other weighed 24 ounces. They both lived to adult life; the larger married and was the mother of two children, which she bore easily. The other did not marry, and although not a dwarf, was under-sized; she had her catamenia every third week. Post describes a 2-pound child.

On the other hand, there have been infants characterized by their enormous size at birth. Among the older writers, Cranz describes an infant which at birth weighed 23 pounds; Fern mentions a fetus of 18 pounds; and Mittehauser speaks of a new-born child weighing 24 pounds. Von Siebold in his "Lucina" has recorded a fetus which weighed 22 1/2 pounds. It is worthy of comment that so great is the rarity of these instances that in 3600 cases, in the Rotunda Hospital, Dublin, only one child reached 11 pounds.

There was a child born in Sussex in 1869 which weighed 13 1/2 pounds and measured 26 1/2 inches. Warren delivered a woman in Derbyshire of male twins, one weighing 17 pounds 8 ounces and the other 18 pounds. The placenta weighed 4 pounds, and there was an ordinary pailful of liquor amnii. Both the twins were muscular and well formed; the parents were of ordinary stature, and at last reports the mother was rapidly convalescing. Burgess mentions an 18-pound new-born child; end Meadows has seen a similar instance. Eddowes speaks of the birth of a child at Crewe, a male, which weighed 20 pounds 2 ounces and was 23 inches long. It was 14 1/2 inches about the chest, symmetrically developed, and likely to live. The mother, who was a schoolmistress of thirty-three, had borne two previous children, both of large size. In this instance the gestation had not been prolonged, the delivery was spontaneous, and there was no laceration of the parts.

Chubb says that on Christmas Day, 1852, there was a child delivered weighing 21 pounds. The labor was not severe and the other children of the family were exceptionally large. Dickinson describes a woman, a tertipara, who had a most difficult labor and bore an extremely large child. She had been thirty-six hours in parturition, and by evisceration and craniotomy was delivered of a child weighing 16 pounds. Her first child weighed 9 pounds, her second 20, and her third, the one described, cost her her life soon after delivery.

There is a history of a Swedish woman in Boston who was delivered by the forceps of her first child, which weighed 19 3/4 pounds and which was 25 3/4 inches long. The circumference of the head was 16 3/4 inches, of the neck 9 3/4, and of the thigh 10 3/4 inches.

Rice speaks of a child weighing 20 1/4 pounds at birth. Johnston describes a male infant who was born on November 26, 1848, weighing 20 pounds, and Smith another of the same weight. Baldwin quotes the case of a woman who after having three miscarriages at last had a child that weighed 23 pounds. In the delivery there was extensive laceration of the anterior wall of the vagina; the cervix and perineum, together with an inch of the rectum, were completely destroyed.

Beach describes a birth of a young giant weighing 23 3/4 pounds. Its mother was Mrs. Bates, formerly Anna Swann, the giantess who married Captain Bates. Labor was rather slow, but she was successfully delivered of a healthy child weighing 23 3/4 pounds and 30 inches long. The secundines weighed ten pounds and there were nine quarts of amniotic fluid.

There is a recent record of a Cesarian section performed on a woman of forty in her twelfth pregnancy and one month beyond term. The fetus, which was almost exsanguinated by amputation, weighed 22 1/2 pounds. Bumm speaks of the birth of a premature male infant weighing 4320 gm. (9 1/2 pounds) and measuring 54 cm. long. Artificial labor had been induced at the thirty-fifth week in the hope of delivering a living child, the three preceding infants having all been still-born on account of their large size. Although the mother's pelvis was wide, the disposition to bear huge infants was so great as to render the woman virtually barren.

Congenital asymmetry and hemihypertrophy of the body are most peculiar anomalies and must not be confounded with acromegaly or myxedema, in both of which there is similar lack of symmetric development. There seems to be no satisfactory clue to the causation of these abnormalisms. Most frequently the left side is the least developed, and there is a decided difference in the size of the extremities.

Finlayson reports a case of a child affected with congenital unilateral hypertrophy associated with patches of cutaneous congestion. Logan mentions hypertrophy in the right half of the body in a child of four, first noticed shortly after birth; Langlet also speaks of a case of congenital hypertrophy of the right side. Broca and Trelat were among the first observers to discuss this anomaly.

Tilanus of Munich in 1893 reported a case of hemihypertrophy in a girl of ten. The whole right half of the body was much smaller and better developed than the left, resulting in a limping gait. The electric reaction and the reflexes showed no abnormality. The asymmetry was first observed when the child was three. Mobius and Demme report similar cases.

Adams reports an unusual case of hemihypertrophy in a boy of ten. There was nothing noteworthy in the family history, and the patient had suffered from none of the diseases of childhood. Deformity was noticeable at birth, but not to such a degree relatively as at a later period. The increased growth affected the entire right half of the body, including the face, but was most noticeable in the leg, thigh, and buttock. Numerous telangiectatic spots were scattered irregularly over the body, but most thickly on the right side, especially on the outer surface of the leg. The accompanying illustration represents the child's appearance at the time of report.

Jacobson reports the history of a female child of three years with nearly universal giant growth (Riesenwuchs). At first this case was erroneously diagnosed as acromegaly. The hypertrophy affected the face, the genitals, the left side of the trunk, and all the limbs.

Milne records a case of hemihypertrophy in a female child of one year. The only deviation from uniform excess of size of the right side was shown in the forefinger and thumb, which were of the same size as on the other hand; and the left side showed no overgrowth in any of its members except a little enlargement of the second toe. While hypertrophy of one side is the usual description of such cases, the author suggests that there may be a condition of defect upon the other side, and he is inclined to think that in this case the limb, hand, and foot of the left side seemed rather below the average of the child's age. In this case, as in others previously reported, there were numerous telangiectatic spots of congestion scattered irregularly over the body. Milne also reported later to the Sheffield Medico-Chirurgical Society an instance of unilateral hypertrophy in a female child of nineteen months. The right side was involved and the anomaly was believed to be due to a deficiency of growth of the left side as well as over-development of the right. There were six teeth on the right side and one on the left.

Tags: Disorders and Diseases