Knot in the Umbilical Cord

D. E. Wells
1877 Boston Medical and Surgical Journal  
its few luxuries, and its faith in the enjoyment of the moment that can make such a sketch appreciable. In bustling, ambitious America it would typify a torpidity of thought, stupidity of existence, and a view of life materialistic if it did not merit the name of philosophic. Such is the average German medical student, whose manner of living is as unwelcome to the foreigner as his advantages are coveted. A system of six weeks' courses has been organized this year in Berlin to retain, if
more » ... , the great numbers of German and foreign students who go to Vienna to develop themselves in special directions. Since the famous days of medicine in Paris, Vienna has become the centre of the medical world of Europe. Berlin has been losing in numbers, on account of this systematic and concentrated but in many respects faulty system of study. A large number of the faculty, privat-docents, and assistants have organized courses, distinct from official instruction, which began with the middle of March and will continue until May. Some of the best names of the faculty are upon the list while some of the most popular specialties are the least represented. Of the latter are the courses in physiology, diseases of the nervous system, otology, diseases of the mouth and teeth, electro-therapy, dermatology, and syphilis. The largest representation of teachers is in the department of state medicine and hygiene, the latter embracing microscopic as well as macroscopic examinations. The course on normal histology by Orth lasts two months, while Langenbeck, as for a few years past, continues his valuable course of surgical operations on the cadaver at six o'clock in the morning through the summer semester. For a first effort the plan is an extensive one, but will undoubtedly bear improvement. Its disadvantages are that the time is restricted to but one part of the year, whereas in Vienna courses are in operation every day in the year. Another serious objection is found in the concise sentence at the end of the prospectus, namely, three hundred marks (about seventy-five dollars) must be guaranteed by each class of students at the beginning of the course, classes to consist of not more than from ten to twelve. Foreigners will recognize a characteristically German style of business in this codicil, and German students will be the first to run away from it. Yours truly, Med. Berlin, March 31, 1877. KNOT IN THE UMBILICAL CORD. Messrs. Editors, -October 29, 1876, I was called to attend Mrs. J. S. W. in her fifth labor, the previous ones having been natural. At this time all went well till about the commencement of the second stage, when she complained of the excessive motion of the child, and such motion was very apparent to the by-standers. It ceased, and the child was born without anything to complicate matters, but it was born " still," nor could I establish respiration, although I tried quite a long time. On searching for the cause of the death of the child, I found a knot in the umbilical cord, at about one foot from the placenta. The cord was very long (four feet and ten inches by actual measurement) and was wound about the body and limbs of the child. I could not tie the cord so firmly as this was tied. It was completely constricted at the point, and of course no blood could pass. The mother noticed the stoppage of the motion of the child about an hour before its birth. I have not noticed this state of things as being spoken of in any of the books. The mother did well.
doi:10.1056/nejm187705100961911 fatcat:m7eoiz7bxzevhhlzrvpydd64vm