Haemorrhage from the Fallopian tube without evidence of tubal gestation / shown by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
[1898]
Catalogue details

Licence: Public Domain Mark

Credit: Haemorrhage from the Fallopian tube without evidence of tubal gestation / shown by Alban Doran. 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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    I must admit that I am very suspicious of alleged cases of haemorrhage from the tube into the peritoneum not due to ectopic gestation. On the ground of accurate observa- tion modern teaching encourages that suspicion. To take the opinion of two distinguished teachers who have issued treatises within the present year, we find that our old president, Dr. Herman, says, “1 am not'satisfied that there is such a condition as metrorrhagic luematocele, meaning by that, haemorrhage from the uterus escaping by the Fallopian tube into the peritoneum. 1 think that cases appearing to be such are either tubal gestation, or cases of haemorrhage from the tube itself of unknown causation.”* Labadie-Lagrave insists on the very valid objections to Bernutz and Guerin’s theory of reflux of blood into the peritoneum from the uterus. Trousseau and Fernerly traced haemorrhage out of the ostium to a kind of epistaxis, an abnormal increase of anatomical oozing. Labadie-Lagrave attaches no importance to this hypo- thesis.t The earlier theories were very plausible, menorrhagia from the tube or epistaxis sounding quite natural, but they were advanced before the days when the microscope was made to reveal chorionic villi in clots. Yet, though it is admitted that the great majority of cases of haamatosalpinx are due to tubal gestation, and that nearly all cases of haemorrhage from the ostium signify tubal abortion, exceptional conditions are possible. I made use of the term “ epistaxis ” above. Dr. Walter Griffith showed us here ten years ago the internal organs from a single nulliparous girl, aged 18, who died from uncontrollable epistaxis and menorrhagia. J The uterine * ‘Diseases of Women,’ 1898, p. 308. f Labadie-Lagrave et F. Legueu, ‘ Traits Medico-Chirurgical do Gyne- cologic,’ 1898, pp. 1119, 1120, nnd 1122. J “ Hmmatoma and Hamiatosalpinx,” ‘Trans. Obstefc. Soc.,’ vol. xxix, p. 397. The specimen is in the museum, St. Bartholomew’s Hospital, Path. Series, No. 2934a. The next specimen, No. 2934b, is very similar. A tri-