On malformations of the organs of generation. 2nd series. Foetation in a rudimentary uterine cornu / by William Turner.

  • Turner, Wm. (William), Sir, 1832-1916.
Date:
1866
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Licence: Public Domain Mark

Credit: On malformations of the organs of generation. 2nd series. Foetation in a rudimentary uterine cornu / by William Turner. 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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    n which the fertilization of the ovum had been effected in these The only authors, so far as I am aware, who enter into the xises. consideration of these questions are Ingleby and Kussmaul. [ngleby1 considers that the time of occurrence of the impervious state of the canal is quite a matter of speculation, 11 if a congenital malformation, seminal contact is out of the question, and we raise he almost exploded doctrine of absorption.” Kussmaul (p. 164) :hinks “ it is improbable that such a canal had not existed before :he conception, and it is equally improbable that the connecting- hand would have been originally solid. It is more probable that t had become closed up in consequence of the pregnancy, the closure occurring partly through pressure of the widened blood- vessels, and partly through a decidua-like growth of the mucous imembrane of the connecting canal, as was observed in the case of IRokitansky.” I am by no means disposed to accept Kussmaul’s argument on this natter as final and conclusive, for there does not seem to me to be uifficient evidence to show that, during the performance of any physiological process in which enlargement of the bloodvessels occurs, the pressure which they may exercise on surrounding parts -s sufficient to occasion closure of such a canal as may have been supposed on Kussmaul’s theory to have traversed the pedicle. In i oases of true tubal conceptions, for example, where considerable ■mlargement of the vessels occurs, the closure of the tube does not lecessarily occur beyond the immediate seat of the sac containing he embryo. If external pressure is to be regarded as a cause capable of producing closure of the canal, supposing one to have been present, then I should think the hypertrophy of the muscular fibres of the pedicle taking place during gestation would be a much more efficient agent in the process than the pressure of surrounding vessels, as the canal would, in all probability, have been more immediately invested by them than by the vessels. But here, iagain, there is a want of evidence that such an effect would have been produced, for hypertrophy of the walls of a gland-duct does not necessarily occasion obstruction of its canal. Neither does KKussmaul’s theory of the blocking up of the canal by a decidua- like membrane, so that it could no longer be recognisable, seem to me to be tenable. For the question is not one of simple closure of orifices, such as so often occurs during pregnancy by the forma- tion of the decidua at the uterine ends of the Fallopian tubes, but of the complete obliteration, so that no trace could be discovered after a most careful examination, of a canal between one and two inches in length. The case of Rokitansky, which Kussmaul advances in support of his theory, does not, indeed, bear it out; for though it is stated that the canal was lined by a decidua, yet 'Rokitansky makes no mention of its being obliterated, and he dis- tinctly describes its orifice as situated above the internal os. Again, 1 Edinburgh Medical and Surgical Journal, vol. xlii. p. 350. 1834. ■