The Foetal Circulation

This little book first appeared on the public stage to a small audience in 2011. The 2019 6th edition now bows out for the last time. There had to be further editions after the first when the author, his most severe critic, introduced new ideas and corrected the errors of the previous ones. But running through them all has been the strong thread of his conviction that the placental supply for the foetus feeds the left atrium, not the right, and that it is the foetus which is delivered: the baby is born after the delivery when the first deep breath is taken. In this final edition the author shows the correct supply for the left atrium by some fundamental facts of physiology and by direct observations of the foetus: human and sheep, which demolish the long-established orthodox accounts. One of his glaring errors in the 4th version was to deny the lungs a pulmonary circulation. In this present edition he not only corrects himself, but uncovers the full pathway of this circulation, which shows the course taken by the arterial supply and the venous return. There is a comprehensive valuable account of the foramen ovale, which, like many of the other aspects of this work, is entirely new. The unique characteristics of the foetal heart sounds are described, which any lady in the later months of pregnancy may hear with a Doppler monitor, and which confirm that the placental fl ow enters the left atrium. The invisible birth changes which have never been seen, are guessed at in full detail. The work is generously illustrated with diagrams, drawings and photos from the hands of the author.
About the Author: The author's father was the manager of a biscuit factory in an industrial area of north west London. He had served in the Great War, and after the war his first wife died in the 1919 flu pandemic, leaving him with a young daughter. He remarried and had another four children, Alan being the second. With scant formal education themselves, he and his wife were able to off er all the children a good education, and to Alan a medical one as well. It was during a biology class in his first year in the medical school that the author first heard about two streams of blood in the same chamber of the heart. In 1956, 'by a set of curious chances' (The Mikado), the author found himself in the setting he had dreamt about when he was a little boy: practising medicine in rural Africa. This was in Nyasaland, part of the former Central African Federation of Rhodesia and Nyasaland. (Now Zambia, Zimbabwe and Malawi). In 1962 he was posted to Zomba as medical superintendent and met Pauline who had been born in the same hospital 21 years previously. The following year they were married, and immediately after the reception left for Fort Victoria in Rhodesia, where he had been offered the post of medical superintendent. Those were momentous times: bringing up a young family in a rapidly changing African environment and practising medicine in the midst of it. The story would make interesting reading, but the author has put it aside and only shown the details of his investigations of the foetal circulation in his little book.