The pathology and treatment of diseases of the ovaries / by Lawson Tait. --.

  • Tait, Lawson, 1845-1899.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: The pathology and treatment of diseases of the ovaries / by Lawson Tait. --. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    of very narrow calibre. From this point it extends outward for a distance varying in the adult from three to five inches, its diameter increasing slightly as it leaves the uterus, and con- tracting again at the ostium abdominale, where it opens out into the infundibulum. It consists of three coats, one derived from the folding over it of the peritoneum, as already described. The greater part of its wall is therefore in direct contact with the out- side surface of the peritoneum. The lesser portion of the wall is in contact with the cellular tissue, which occupies the space between the two folds of the broad ligament, at the lower aspect of the tube (meso-salpinx) (Fig. 2). The middle coat is muscu- lar, and consists of a faint layer of longitudinal fibres externally, and a much thicker layer of circular fibres internally. The lon- gitudinal fibres, according to my own observations, disappear entirely about the menopause, or soon after. The internal or mucous surface is thrown into a series of delicate longitudinal folds by the action of the circular fibres, an arrangement exactly similar to that which obtains in the oesophagus and urethra. The mucous surface of the tube is lined with ciliated epithelium, the movements of which are directed toward the uterus, and the function of which is certainly to prevent the passage of sperma- tozoa up the tube. If this were not so, tubal pregnancy would be much more common than it is. The movement of the cilia also undoubtedly aids the passage of the ovum down the tube, and prevents its adhesion to the wall should the ovum happen to become occupied by spermatozoa. At the ostium abdominale the tube expands trumpet-like, the expansion being formed by a series of fimbriae, or laciniae, of two sizes, major and minor. This infundibulum (known also as the morsus diaboli) (a, Fig. 1) is large enough to embrace about one-third of the ovary, and seems to have a curious tendency to enlarge as the ovary en- larges in diseased conditions. The major fimbriae have the mi- nor fimbriae arranged between them somewhat irregularly, and when a Graafian follicle is nearly ready to burst, the infundibu- lum is said to be applied over the part of the ovary where the ripe follicle is and becomes attached to the surface by a slight cellular adhesion. If so, there must be some peculiar and wholly unknown selective influence which governs this adhesion, but it clearly is a mechanism not of universal or constant accuracy; for I have frequently, during abdominal sections, seen follicles just on the very point of bursting, over which the infundibulum was not fixed. In such a case the ovum must fall free into the peritoneal cavity, and there probably dies in the great majority of instances. There is reason to suspect, however, that, in ex- ceptional instances, it there undergoes cystic expansion.