Tubal gestation, with special reference to its early diagnosis and treatment : an address delivered before the Oxford Medical Society, November 12th, 1897 / by Charles J. Cullingworth.

  • Charles James Cullingworth
Date:
[1898]
Catalogue details

Licence: Public Domain Mark

Credit: Tubal gestation, with special reference to its early diagnosis and treatment : an address delivered before the Oxford Medical Society, November 12th, 1897 / by Charles J. Cullingworth. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    lO first month. The blood is poured out into the space at that time existing between the chorion and amnion—the‘subchorionic space, the usual results being the distension of the sac by effused blood, the compression of the amnion and its cavity by the extravasated blood, the destruction of the life of the embryo, and the provoking of external haemorrhage in addition to the internal as a con- sequence of the disturbed relations of the ovum with the tube wall. When an early tubal ges- tation undergoes rupture, it almost invariably does so, not as the mere consequence of the failure of the Fallopian tube to adapt itself to the needs of the growing ovum, but owing to the occurrence of such a series of events as I have just enumerated. The sudden increase in the size of the ovum caused by haemorrhage puts a new and sudden strain upon the already thin and stretched tube wall, and a covering that might have been quite capable of adapting itself to the gradual and uncomplicated increase in size of a developing ovum, gives way under the more sudden strain occasioned by the formation of a tubal mole. This is the ordinary mode in which rupture is caused. A slight effort or a slip in walking may determine the precise moment of rupture, but the main cause is the more or less sudden demand made on the capacity of the tube by the occurrence of haemorrhage between and outside the foetal membranes. But my experience goes to show, and the experi-
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