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The female members of a hæmophilic stock are often very prolific, and there is usually a predominance of daughters in their families. The disease is met with in boys who are otherwise healthy, and usually manifests itself during the first few years of life. In rare instances profuse hæmorrhage takes place when the umbilical cord separates.
The child is removed by the mabalian who, in cutting the umbilical cord, makes use of the kind of knife used by the members of the child's sex, otherwise the wound would never heal. The child is placed on a piece of soft betel bark, "for its bones are soft and our hands are hard and are apt to break the soft bones," then water is poured over it and its body is rubbed with pogonok.
His case was that of a fetus, the product of a miscarriage of traumatic origin; the soft tissues were almost cut through and the bone denuded by the limb resting on one of the two umbilical cords, not encircling it, but in a sling. The cord was deeply imbedded in the tissues.
For five months the work of putting a handle on a parang and fastening it with damar must not be done else both mother and child would die. The name given the child when the umbilical cord is cut remains unchanged. A person must not give his own name nor call by the name of his father, mother, father-in-law, mother-in-law, grandfather or grandmother, whether they are alive or dead.
There was no possibility that this was a case of retained secundines. Anomalies of the Umbilical Cord. Absence of the membranes has its counterpart in the deficiency of the umbilical cord, so frequently noticed in old reports. The Ephemerides, Osiander, Stark's Archives, Thiebault, van der Wiel, Chatton, and Schurig all speak of it, and it has been noticed since.
He teaches that mothers may often be able to cure hernias, both umbilical and inguinal, in children by promptly taking up the treatment of them as soon as noticed, bringing the edges of the hernial opening together by bandages and then preventing the reopening of the hernia by prohibiting wrestling and loud crying and violent motion.
Blundell says that he knew "a boy who was literally and without evasion with child, for the fetus was contained in a sac communicating with the abdomen and was connected to the side of the cyst by a short umbilical cord; nor did the fetus make its appearance until the boy was eight or ten years old, when after much enlargement of pregnancy and subsequent flooding the boy died."
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