On a hitherto undescribed disease of the uterus, namely, unnatural patency of the inner extremity of a fallopian tube / by J. Matthews Duncan.

James Matthews Duncan

Date:: [1856]

Credit: On a hitherto undescribed disease of the uterus, namely, unnatural patency of the inner extremity of a fallopian tube / by J. Matthews Duncan. Source: Wellcome Collection.

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siderably dilated, so that there was little doubt that the sound had passed into it.”1 In other instances, this morbid condition is left to be inferred with more or less of assurance. It is well known that numerous cases exist of haemorrhage into the Fallopian tubes, and of collections of fluid or dropsies in them. In such, the tubes are in general actually or potentially sealed at both extremities. Sometimes, how¬ ever, the blood has found its way into the peritoneum. At other times, the blood or other collected fluid has been discharged per vaginam. Thus, Boivin and Duges2 mention a case, related by Frank, where serous matter from the Fallopian tubes was discharged through the uterus and vagina, to the extent of a pint a day ; the patient died of consumption, and thirty-one pints of aqueous and gelatinous matter were found in the left Fallopian tube. To this case numerous analogues may be found in cases of discharge from ovarian cysts through the tubes. This state of matters is sometimes described as the hydrops tubarum profluens, and is discussed under that title by Kiwisch.3 This author, indeed, describes these tubes, as sometimes, during menstruation, yielding a bloody discharge. A case of Brodie’s is, on the other hand, often alluded to, where retained menstrual secretion passed from the uterus into the abdo¬ men, through a tube. We also find Rokitansky and Kiwisch both describing catarrh of the tubes as co-existing with the same disease of the uterus and vagina. O The evidence upon which I have chiefly relied for the diagnosis of this disease, is afforded by the use of a probe. In the cases, upon which I chiefly build, there was no tumour of the womb, or other pelvic viscera, to cause confusion. The probe, passed through the os uteri, advanced with the least possible pressure, so far as to be cer¬ tainly beyond the uterus. Indeed, however far it was advanced, no obstacle was felt to pressing it still farther, except its own length, and the motive of caution. Its point could be felt through the abdominal wall far above the pelvis. In passing, it always took a decidedly lateral direction. If, in the early part of its progress, its point were kept directed to the unaffected side, it experienced an arrestment; when changed to the other side, it glided forwards with the greatest ease. Under these circumstances, I submit that it must have passed through a dilated Fallopian tube into the abdominal cavity. This phenomenon I have, in several cases, observed. In the two examples, the data of which I shall presently give, there were, in addition, present, anomalous symptoms in the one ; and, in the other, there were copious haemorrhages, probably coming from the affected tube. That the probe did not enter the track of an abscess, is evident, 1 Lancet II., 1849, p. 118. 2 Diseases of the Uterus. Heming’s Translation, p. 501. 8 Klinische Vortrdge. II. Abtheilung, s. 214.

On a hitherto undescribed disease of the uterus, namely, unnatural patency of the inner extremity of a fallopian tube / by J. Matthews Duncan.

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