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Discussion of Doctor Humphrey's Presentation

DOCTOR DIXON: Could you comment on the length of time during which these reflexes can be elicited from the fetuses? DOCTOR HUMPHREY: Length of time depends on age. It is a matter of eight to ten minutes, maybe only five, after delivery of the fetus in the operating room. Whether you can get the reflexes or not depends on the anesthetic given the mother. For best results, you need a spinal procaine hydrochloride (Novocain), or its equivalent as an anesthetic and reflexes also depend on whether the mother has been given morphine or some other drug with a similar effect before the operation. As the fetus gets older and approaches the age of viability, you can elicit reflexes for a longer period of time. DOCTOR SPERBER: It is interesting to postulate whether mouth opening is necessary for cavitation formation in the temporomandibular joint. If there are no such opening reflexes, wouldn't ankylosis of the joint ensue? DOCTOR HUMPHREY: I think not. There is some evidence, both clinically and experimentally, that limitation of movement will result in joint deformity. But I don't think it applies in this case. There is no critical period for joint cavity formation. Development of the temporomandibular joint takes place over a relatively long period of time and mouth opening reflexes might be suppressed for a short interval at some stage, but they are not going to be suppressed for any great period of time. From eight and a half weeks of menstrual age until birth, they occur in one form or another. I doubt very much if there would be more than an alteration in the developmental time at which cavitation in the joint begins. DOCTOR POSNER: What was the reason for the caesarean removals of the embryos? DOCTOR HUMPHREY: They were all removed to save the life, health, or sanity of the mother, and the diagnoses varied from pulmonary tuberculosis, nephritis, severe mitral stenosis and everything else along that line, as well as the RH factor.