A seven-month fetus is recognizably human in its formed organs and external parts but remains immature in fat stores, respiratory function, temperature control and feeding coordination. The month count must be stated: calendar months, four-week obstetric months and time since conception are not interchangeable.
A useful modern benchmark is around 28 completed gestational weeks, counted from the last menstrual period, about two weeks more than the usual time since fertilization. At that stage a typical crown-to-heel length is about 38 cm and mass about 1 kg, with substantial normal variation. Those are illustrative modern averages, not measurements of a particular fetus or exact historical thresholds for a seventh month. A historical count from conception would place the same numerical week count later in modern gestational dating.[ref][ref]
The body is slender compared with a term newborn because subcutaneous fat is still limited. The skin is relatively thin and reddish, with wrinkles, lanugo and a variable covering of vernix caseosa. Hair and nails are present but their growth and the firmness of the ear cartilage remain immature. The eyelids have separated and can open around this period; this should not be confused with adult visual acuity or fully mature pupillary responses. Limb movements occur, but sustained flexor posture and coordinated behaviour are less developed than at term.[ref]
The major organs are present, yet their organization and functional reserve continue to mature. The brain is growing rapidly and its surface folding increases. The lungs are developing gas-exchanging regions and pulmonary surfactant production, but an early birth can still entail serious respiratory difficulty. Fetal respiratory movements do not demonstrate that the lungs are already performing ordinary air breathing: before birth the placenta supplies gas exchange. Fetal circulation still includes its characteristic shunts. Genital appearance and testicular descent, when relevant, can contribute to maturity assessment but do not provide a precise independent calendar.
Survival after birth is possible, especially with current neonatal support, but viability is a probability conditioned by maturity, circumstances and available care, not a switch thrown on one date. Modern intensive-care results must not be represented as outcomes achievable in 1864. Nor is there a physiological rule that a healthy eight-month fetus is intrinsically less viable than a seven-month fetus. A description of several concordant maturity features is more defensible than assigning an exact age or prognosis from size alone.
“Atelectasis pulmonum” means incomplete expansion or collapse of lung air spaces; in the newborn it classically describes portions that have not expanded adequately after birth. Modern atelectasis also includes collapse of previously aerated lung. The older distinction between primary non-expansion and secondary collapse is useful when reading this paper.
The affected lung is airless, often dark and firm, with reduced volume, a depressed surface and little or no crepitation. Failure of inspiratory effort, obstruction of a bronchus by secretions, and external compression are different routes to this appearance. Modern physiology adds the role of pulmonary surfactant in opposing alveolar collapse; deficiency in premature infants belongs to neonatal respiratory distress syndrome, not an explanation the 1867 question itself supplies.[ref]
The main historical confusion was with pneumonia. A pre-1867 review of Charles West's work distinguishes primary non-expansion from secondary collapse, and contrasts both with pneumonic hepatization. A collapsed region loses air and volume; inflammatory pulmonary consolidation fills air spaces with exudate. Both can look solid.[ref]
The classical experiment introduces air through the trachea or an appropriate bronchus while the affected region is observed. Uncomplicated collapsed lobules can expand and regain buoyancy; inflation does not simply remove inflammatory exudate. The historical review describes this distinction.[ref] The experiment's interpretation requires more than one observation: whether a region takes air, whether its volume changes, and whether its contents show inflammation are different measurements. Cut-surface inspection and histology test the last point directly. Floating or sinking alone cannot distinguish all mixtures of collapse, fluid and pneumonia, and cannot reliably establish whether an infant was born alive.
Other potential confusions include pulmonary oedema, pulmonary haemorrhage, and compressed lung beside a pleural effusion or pneumothorax. Fluid or blood in the air spaces differs from collapse alone, although the conditions can coexist; external compression can actually cause atelectasis. Pulmonary hypoplasia is different again: an underdeveloped organ is not merely an otherwise normally formed organ awaiting inflation.[ref]
Reduced aeration is the observation; non-expansion, obstruction, compression and inflammatory consolidation are competing or coexisting explanations. Gross inspection, controlled inflation and histology help discriminate them.