354 MEDICAL JTJEISPRUBENCE uterine contractions may be so powerful as to fracture the cranial bones of the fcetus. Cater records the case of a woman, aged 32, who expected her first delivery about December 24, 1901. A month before the anticipated event there was haemorrhage per vaginam following a " very bad dream ", the patient leaving her bed during sleep. The child was then living and occupied the left dorso- anterior transverse position. l*be external os barely admitted the finger tip. The haamorrhage ceased within forty-eight hours On the 6th December labour pains commenced at 11 a.m. At 5 p.m. the doctor on his arrival found that the child was born and lying in its back with both legs and thighs flexed, the feet resting against the mother's left buttock. The cord was almost black and without pulsation, but there was no discoloration about the body. The eyes and tongue protruded, the head presenting the appearance of craniotomy forceps having been employed. The frontal bone was fractured, the fracture extending from above the left orbit to the right malar bone. The occipital bone was fractured into two unequal pieces. The child was full-term and weighed 6J Ibs. There was no such pelvic defor- mity as to be responsible for the crushing of the child's head.11 5. Death of the Mother. — When the mother dies in the act of delivery, the question arises as to how long a child may live in utero after her death. The time depends upon the cause of the mother's death. If ,4§ath occurs slowly from haemorrhage, there is very little chance of saving the child, but it may be saved if an attempt is made to extract it soon after the sudden death of the mother from some accident, if she was previously in good health. Rosin 12 reports a case in which he delivered a full-time male child, weighing 7| pounds, "by Csesarian section in a state of asphyxia livida a quarter of an hour after the mother's death. Twenty minutes3 artificial respiration and alternate immersions in hot and cold baths revived the child, who cried lustily. Dixon Hughes13 mentions a case in which a live child, weighing 9 pounds and 4 ounces, was delivered by forceps 9 to 10 minutes after the sudden death of the mother. A case is also recorded where twins were delivered by Caesarian section 5 minutes after the death of a Chinese woman, aged 38 years.14 After Birth, — X^^JSaxfibcajtio]^^ may die from suffocation after birtfc,' If it is born under a caul, i.e. with membranes over the head thus covering the mouth and nostrils. The child may also die from suffocation, if its face is pressed accidentally in the clothes or submerged accidentally in the discharges, such as blood, liquor amnii or meconium. 2. Pt^ipitate Labour.— In precipitate labour a child may be born wiffiout the mother's kncJwTSge and may die from suffocation by falling accidentally into a privy pan containing faeces, or from drowning by falling into a chamber pot containing urine, fi the woman is standing erect at the time, the child may be forcibly shot down from her genital canal, and may die from fracture of the skull caused by a fall on a hard floor. Ordinarily, a drop of thirty inches which is the average distance of the female genitals from the ground in the erect posture is sufficient to cause fracture of the sbiH bones, but a fall of eighteen inches may fracture them as well. In such a case the child is small as compared with the size of the pelvis of IB?8* mother and one or both parietal bones may be fractured ; in some cases the fracture may radiate into the frontal, and squamous portion of the temporal belie. Mud, sand or gravel may be found in the hair or injured scalp of the child, if the floor is covered with such material. The cord is either torn across, or the placenta is expelled with the child. Haemorrhage from the torn cord, as a rule, stops owing to the contraction of the muscular wall of 11, ,$nL Med. Jotm, May 17, 1902, p. 1207. !& I^ei, April 16, 1927, p. 820 ; see also Joyce Morgan, Lancet, Aug. 3, 1940, p. m B. HA Jcmr. Ausfarl, Oct 2» 1943, Vol. 30, p. 264 ; Med.~Leg. and Criminal Rev^ Vbl mj%J m feu* JL m; see also KfeaM Nafl, Lancet, April 24, 1948, p. 654; Walter «B* Hsfews, Brit Me& Jtomr«» ApS 22, B50, p. 938 ; Kronick, M., New £ug. J. I>ee, 14, 1950, p. 953. 14 W. C^m Sgam, B^t JfeeL Jotttv, Sep. 1, 1951, p. 546.