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GRAPHIC ILLUSTRATIONS
OF
ABORTION
AND
THE DISEASES OF MENSTRUATION.
CONSISTING OF
TWELVE PLATES FROM DRAWINGS ENGRAVED ON STONE,
AND COLOURED BY MR. J. PERRY,
AND
TWO COPPER-PLATES
FROM THE PHILOSOPHICAL TRANSACTIONS,
COLOURED BY THE SAME ARTIST.
THE WHOLE
REPRESENTING FORTY-FIVE SPECIMENS OF ABORTED OVA AND ADVENTITIOUS
PRODUCTIONS OF THE UTERUS,
WITH
PRELIMINARY OBSERVATIONS, EXPLANATIONS OF THE FIGURES
AND
REMARKS,
ANATOMICAL AND PHYSIOLOGICAL.
BY
A. B. GRANVILLE, M.D., F.R.S., F.L.S., F.G.S., F.R.A.S.,
ETC. ETC. ETC.
FOR FIFTEEN YEARS PHYSICIAN-ACCOUCHEUR TO THE WESTMINSTER GENERAL
DISPENSARY, AND DURING TEN YEARS PHYSICIAN TO THE BENEVOLENT LYING-IN
INSTITUTION.
LONDON:
PRINTED FOR JOHN CHURCHILL,
Medical Bookseller and Publisher,
16, PRINCES STREET, SOHO.
MDCCCXXXIV.
G. WOODFALL, ANGEL COURT, SKINNER STREET, LONDON.
HENRICO HALFORD,
BARONETO,
EX GUELPHORUM EQUITUM PRIMÂ COHORTE; BRITANNIARUM REGIS ARCHIATRO;
COLLEGII REGALIS MEDICINÆ LONDINENSIS PRÆSIDI;
MEDICO DOCTO, PERITO, FELICI,
IN OMNI DOCTRINÆ GENERE ILLUSTRI,
OBSERVANTIÆ ET AMICITIÆ ERGO
GRAPHICA HÆC LINEAMENTA
D.D.D.
AUCTOR.
------------------------------------------------------------------------
CONTENTS.
DEDICATION.
Advertisement, XI.
PROLEGOMENA, p. i.–xxi.
Perfect (Normal) Animal Reproduction, prop. 1–3.
Imperfect (Anormal) Animal Reproduction (Abortion) prop. 4–7.
Study of Abortion, prop. 8–12.
CONCEPTION, prop. 13.
Ovulum (Description of before Fecundation), prop. 14–17.
FECUNDATION, prop. 18.
Ovulum (Description of after Fecundation), prop. 19–22.
CORTICAL MEMBRANE of the Ovulum, prop. 23–26.
Deciduous Membrane of the Uterus, prop. 27–31.
Corpora Lutea, prop. 34–37.
Transit, Volume, and First Development of the Ovulum, prop.
38–42.
THE CHORION, prop. 43–44.
Structure, Function and Vascularity of the Chorion, prop. 45–51.
Fluid of the Chorion, prop. 55.
THE AMNION, prop. 54.
Structure, Function and Vascularity of the Amnion, prop. 52–54.
Fluid of the Amnion, prop. 53.
Progressive Increase of the Ovulum, prop. 56.
Independent Life of the Ovulum, prop. 57–59.
Earliest or Mechanical Connection of the Ovulum with the Uterus,
prop. 60.
Metamorphoses of the newly engendered Being, prop. 61.
Growth and Progress of the Embryo and Fœtus, prop. 62–66.
Priority of the Vascular over the Nervous System in the Fœtus,
prop. 67.
Formation of the Blood in the Fœtus, prop. 68.
Formation of the Nerves in the Fœtus, prop. 69.
Apparatus for Digestion, prop. 70.
VESICULA UMBILICALIS, prop. 71.
THE ALLANTOID, prop. 72.
THE UMBILICAL CORD, prop. 73–75.
Omphalo-mesenteric Vessels, prop. 76.
More advanced, or Vascular Connection of the Ovum with the
Uterus, prop. 77,
FIRST FORMATION OF THE PLACENTA, prop. 77.
Cotyledons of the Placenta, prop. 78–80,
Deciduous Vessels of the Placenta, prop. 81–83,
Membrana Propria of the Placenta, prop. 84.
Proofs of the Existence of Deciduous Vessels in the Placenta,
prop. 85.
Deciduous Vessels, form the connecting Vascular Link between the
Uterus and Placenta, prop. 86.
Proofs of it from Anormal Anatomy, prop. 87.
CIRCULATION, Utero-fœtal, prop. 88 and 90.
Recent Fallacies respecting the Structure of the Placenta, prop.
89.
FUNCTIONS OF THE PLACENTA, prop. 91.
Physiological Proofs of the Deciduous and Fœtal Structure of the
Placenta, prop. 92.
NUTRITION of the Fœtus through the Placenta, prop. 93.
Lymphatics and Lymphatic Absorption in the Placenta, prop. 94.
Pretended Nutrition by the Amnionic Fluid, prop. 95–96.
RESPIRATION of the Fœtus in Utero, prop. 97.
Nature of the Changes in the Fœtal Blood, prop. 98.
Bile secreted by the Placenta, prop. 99.
Distinction between Life and Nutrition in the Fœtus, prop.
100–102.
EXPLANATIONS OF PLATES, AND REMARKS.
PLATE I. page 1–6.
SPECIMENS OF VERY EARLY MISCARRIAGES.
Remarks on Fig. 1 and 2. page 2.
Remarks on Fig. 5, 6, 7, 8, 9. p. 5.
PLATE II. p. 7–8.
MISCARRIAGE BETWEEN TWO AND THREE MONTHS.
Remarks on Fig. 10, 11, 12. p. 8.
PLATE III. p. 9–12.
MISCARRIAGE BETWEEN TWO AND THREE MONTHS.
Remarks on Fig. 13, 14, 15. p. 11.
PLATE IV. p. 13–16.
MISCARRIAGE DURING THE THIRD AND BEFORE THE COMPLETION OF THE FOURTH
MONTH.
Remarks on Fig. 16. p. 14.
Remarks on Fig. 17. p. 15.
PLATE V. p. 17, 18.
MISCARRIAGE BETWEEN THE THIRD AND FOURTH MONTH.
Remarks on Fig. 18. p. 17.
Remarks on Fig. 19. p. 18.
PLATE VI. p. 19–24.
MISCARRIAGE BETWEEN FOUR AND FIVE MONTHS.
Remarks on Fig. 20. p. 20.
Remarks on Fig. 21. p. 22.
Remarks on Fig. 22. p. 23.
PLATE VII. p. 25–26.
MISCARRIAGE AT FIVE MONTHS.
Remarks on Fig 1. p. 26.
PLATE VIII. p. 27.
FIRST SPECIMEN OF ABERRANT GESTATION.
Remarks on Fig. 1. p. 28.
PLATE IX. p. 29.
SECOND SPECIMEN OF ABERRANT GESTATION.
Remarks on Fig. 1. p. 30.
PLATE X. p. 33–36.
THIRD SPECIMEN OF ABERRANT GESTATION.
Remarks on Fig. 1. p. 33.
Remarks on Fig. 2. p. 35.
Classification of Erratic (Extra-uterine) Gestation. p. 35.
PLATE X. (A.) p. 37–38.
FOURTH SPECIMEN OF ABERRANT GESTATION.
References to Do. p. 37.
PLATE X. (B.) p. 39–40.
CONTINUATION OF ABERRANT GESTATION.
Remarks on Do. p. 39.
PLATE XI. p. 41–44.
DYSMENORRHOIC ORGANIZATIONS.
PLATE XII. p. 45–51.
POLYMENORRHOIC STRATIFICATIONS.
Remarks on Figs. 1, 2, 3, 4, 5. p. 48.
Classification of the Adventitious Productions of the Uterus. p. 48.
Classification of the Diseases incidental to Menstruation. p. 48–49.
Synopsis of a Work on Abortion. p. 51–52.
LIST OF THE FORTY-FIVE COLOURED FIGURES OF HUMAN OVA, AND ADVENTITIOUS
PRODUCTIONS OF THE UTERUS REPRESENTED IN THE PLATES.
1. Ovulum bigeminum lanuginosum.
2. Ovulum semi-lanuginosum.
3. Ovulum lanuginosum.
4. Ovulum semi-lanuginosum.
5 and 6. Ovula of the same species.
7. Ovum denudatum, or diaphanous Ovum.
8 and 9. Ova of the same species.
10. Ovum piriforme externè opacum.
11. The same laid open.
12. Ovum opacum plethoricum.
13 and 14. Ova semi-coriacea.
15. Ovum omnino opacum rotundum.
16. Ovum pseudo-membranosum.
17. Ovum uviforme.
18. Ovum coriaceum, cum hydrope funis et placentâ hydaticâ.
19. Ovum cum placentâ, nec vasculare nec plene cotyledonica, sed
filiforme. Amnion morbosum.
20. Ovum tuberculosum.
21. Ovum pane solidum. Placenta sarcomatosa cum tuberculis. Involucra
fœtüs solidificata.
22. Ovum cum involucris internis ab amnio-chorionitide condensatis.
23. Ovum fœtiferum optimè conditum, subitò, ab amnio-chorionitide
interfectum.
24. Ovum fœcundum in receptaculo Ovarico.
25 and 26. Ovum fœcundum in receptaculo Tubico.
27 and 28. Ovum fœcundum in receptaculo Interstitiale.
29. Ovum fœcundum in receptaculo Ovarico.
30. The sac of the preceding Ovum laid open.
31. Membrana pseudo-textilis intro-uterina bi-tubulata.
32. Membrana pseudo-textilis intro-uterina sine tubulis.
33. Coagulum intro-uterinum hæmatosum pseudo-membranaceum incavum.
34. Coagulum intro-uterinum hæmatosum laminare cavum.
35. Coagulum intro-uterinum spongiosum cavum, interne velatum.
36 and 37. Coagulum intro-uterinum, interne solidum, externe
membranaceum.
38. Mola avellana tunicata.
39. The same laid open.
40. Mola avellana nuda.
41. The same laid open.
42. Mola conchula.
43. The same laid open.
44. Mola Mytilus.
45. The same laid open.
N. B. In the last Plate, the figures 2 and 3 should be reversed, in
order to correspond with the text or printed explanations.
ADVERTISEMENT.
I submit to my professional friends and acquaintances, as well as to all
those medical brethren who take an interest in the progressive
advancement of the sciences they cultivate, a series of beautifully
executed Drawings of anatomical preparations, intended to explain and
illustrate the important subjects of “Abortion”, and “The Diseases
incidental to Menstruation”; subjects in which all classes of the
medical profession, whether specifically devoted or not to obstetrical
practice, are equally interested. The drawings speak for themselves. The
Artist, under my immediate and constant superintendence, and with the
anatomical preparations in every case before him, explained and
demonstrated to him, has, in the course of six years, been able to
produce twelve plates, containing upwards of forty anatomical figures,
lithographed and coloured by himself, which reflect no small honour on
the arts of this country, and are highly creditable to his abilities.
These plates, I will venture to say, leave nothing to be desired in such
a mode of representing anatomical subjects, (a mode which appears from
the present endeavours to be the best calculated of any for that
purpose,) whilst they remove every cause of regret, hitherto
entertained, that the most successful efforts of anatomical lithographic
representation, of which foreign countries can boast, had never yet been
equalled in England. It may now be asserted that those efforts have been
triumphantly rivalled by Mr. Joseph Perry on the present occasion; and,
in some of the plates, unquestionably surpassed.
Having said thus much in favour of the Artist, I hope I shall be excused
if I add, for myself, that I have selected such specimens only as I
considered likely to illustrate some of the most interesting points of
the physiology of human generation, and which might assist in
unravelling the various practical difficulties which beset that
mysterious question;—that I have chosen those which, I believe, (with
the exception of one or two preparations,) have never been published
before either in this or any other country, and many of which are to be
found only in some private anatomical collection;—that I have explained
them in such a way as to render their meaning and usefulness evident to
all my brethren;—and that, under such circumstances, I venture to
believe that the plates so explained will prove of no inconsiderable
service to every medical practitioner as a work of reference, where
either a private or a public museum is not at hand to solve cases of
doubt.
I am aware that I might have extended this series of representations to
more than double the present number of analogous preparations; but I
purposely limited it to what it is, from a consciousness that any
unnecessary increase in the number of plates, which the peculiarity of
the subject did not absolutely require, would only tend to increase the
bulk, and with it the expense of the “Graphic Illustrations”, without
any adequate or corresponding advantage.
It may, after all, be asked: were these delineations wanted? Were there
not already in existence works of a similar, or at least analogous
character, executed in an equally masterly style, to which the medical
reader and the physiologist could refer for information and in cases of
doubt? I reply, yes, to the first—and negatively, to the second
question.
And first, of the second question. Not to speak of the many authors on
matters of this description, who preceded Dr. Hunter and Professor
Soemmering, in giving representations of the human embryo in many of its
metamorphoses, such as Ruysch, Noortwyk, Albinus, Krapft, Wrisberg,
Camper, Blumenbach, Denman, and others, I am ready to admit that both
Hunter and Soemmering had given to the world delineations, such as are
here referred to, which ought to satisfy the medical profession. The one
in his splendid work on the “Gravid Uterus”, gigantic folio edition—the
other in his no less valuable folio plates of the human embryo. But,
unfortunately, neither of those works can be considered as accessible to
the generality of professional readers, on account of their high price
and rarity; and even if either were accessible, the subjects therein
treated are viewed differently from those collected in the present work.
Those works, moreover, present no coloured specimen of delineations of
parts, most of which, if not all, from that simple circumstance, lose
their principal value;—and as productions of art they are not equal to
what Mr. Perry has enabled me to offer to the public. Soemmering
himself, in his “_Icones Embryonum Humanorum_”, admits, that although
those who had gone before him in the same channel of inquiry, had
produced valuable works and splendid plates, particularly Dr. Hunter and
Dr. Denman; there was yet room for a more complete, and, above all, for
a more minute representation of the metamorphoses of the human embryo.
“_Elegans profecto et utilis admodum speculatio!_” exclaims the veteran
physiologist; and forthwith he proceeds to compare what he had been able
to give to the public on the subject of embryology with that which his
predecessors had done. This leads him to the conclusion that, from
having paid greater attention to minuteness, from being more strictly
accurate, from the advantage of having a better collection of specimens
than fall to the lot of most anatomists, and from the circumstance of
both his delineator and engraver being much superior to those of former
times—he had been able to complete a work of art on the progressive
development of the human fœtus which left those of his predecessors far
behind.
With one or two exceptions, the representations in Soemmering’s work are
simply those of the fœtus in its progressive advancement from the third
week after fecundation, to the fifth or sixth month of gestation. Those
representations have no reference to the whole ovum at those several
periods of fecundation: and they are not coloured. Still they are, as he
has stated, superior as a work of art to any that had appeared before.
Soemmering tells us that he selected for his plates the best specimens
of the human embryo, the best draughtsman, and the most skilful
engraver; and that when he compared those plates with those of
Trioenius, Albinus, Wrisberg, Hunter, and Denman, in order that he might
better understand, explain, and perhaps correct his own: “_magnopere
delectabatur_”, to find, on such a comparison, that the superiority of
his plates was not inconsiderable. Well, then, let the reader who has
the means of doing so, turn to the two folio plates of Soemmering, and
then direct his attention to the fourteen plates contained in the
present volume, and I will abide by their decision whether or no, in all
such delineations as relate to either parallel or identical subjects in
the two publications, the palm of superiority (in every circumstance of
design, precision, and execution,) which Soemmering claimed for _his_
publication, ought not to be yielded by him to _another_ sent forth
under the advantage of recent improvements in drawing, and a newly
invented art admirably adapted for such imitations of nature.
Independently of which advantages there is to be added the charm of
colour—a circumstance which so greatly embellishes, without disfiguring,
truth.
With such impressions, I can feel no hesitation in giving publicity to
my collection; and if in selecting, denominating, and appropriating to
particular views of my own the several specimens I now publish, there
should be found neither taste nor judgment, novelty nor utility, the
blame must rest on me—but the merit of superiority will still remain to
it as a work of art, which, in the department of morbid embryology, has
at present no equal either in England or on the Continent.
Now to the first question—whether these delineations were wanted? I
support the affirmative by appealing to all those of the profession who
have had occasion to be consulted in cases of abortion and the expulsion
of those singular productions of the uterine cavity, which seem
connected with menstruation or faulty conception. Let them say whether a
work, in which the principal of the infinitely varied aborted human ova,
and of the uterine productions alluded to, are faithfully represented,
be not likely to be useful; whether, in fact, it be not wanted—or
whether it exist already anywhere. If the want of such a work be made
manifest, its importance must be self-evident. But that importance is
not a little enhanced when we find Denman—a plain unsophisticated
practitioner—with quite enough of science to constitute him an authority
in physiological questions concerning human generation,—recommending the
inquiry, in his own work on an analogous subject, entitled “Engravings
representing the Generation of some Animals”, in which he has given
three drawings of aborted ova. “It must be allowed”, observes the
Doctor, “that the generality of these things (the aborted ova) are
preserved for their beauty, or as matter of curiosity, rather than of
use. I suspect, nevertheless, that there are some appearances besides
the _vesicula umbilicalis_ not yet perfectly understood, and therefore
recommend the whole subject as worthy of being reviewed”: and, in a
subsequent part, he says, that “in every collection there must be some
example, which may enable us to distinguish the different parts of which
an ovum is composed, the proportion which they bear to each other at
different periods of pregnancy, and sometimes the process of utero
gestation which failed”. What greater encouragement, therefore, needed I
than this opinion and advice of one of the best obstetricians England
can boast of, to select, prepare, and point out the importance of this
species of anatomical and physiological delineations?
I shall conclude, by remarking, that the plates are intended to
illustrate a work “On Abortion and the Diseases incidental to
Menstruation”, which I have been preparing for several years, and a
prospectus of the contents of which will be found at the end of the
present volume. That work will appear, DEO favente, in the course of the
present year; but for the convenience of such persons as may not feel
inclined to purchase it, the collection of plates has been purposely so
arranged, as to be published, with a corresponding text, in a separate
form, and independently of the forthcoming volume.
_Grafton-street, Berkeley-square, 30th March, 1833._
PROLEGOMENA
OF
THE DEVELOPMENT AND METAMORPHOSES
OF
THE HUMAN OVUM.
PROLEGOMENA.
1. The ultimate purpose of nature, in associating the two sexes in the
human species, is to bring to maturity and produce, in a fit state to
live and procreate, a constant succession of individuals, that shall
perpetuate the species to the end of time.
2. This object is invariably accomplished by one uniform series of laws
and phenomena, which have been studiously inquired into, accounted for,
and, in most instances, explained in a satisfactory manner, amounting
almost to demonstration.
3. The study of the function of reproduction, in all the other classes
of animals, affords no other nor any dissimilar evidence. On the
contrary, both by comparison and analogy, the study in question serves
to confirm us in the notion, that Man differs in nought, in this
respect, from the animated beings placed below him in the scale of
creation. One same primary intention is manifest in their sexual
distinctions; the means to ensure the ultimate purpose—their
perpetuation—are the same; the same laws and the same phenomena mark the
appearance, the development, and the final production of successive
generations of individuals.
4. Any deviation from those laws—any violent change in those
phenomena—and, still more so, any impediment to the accomplishment of
the _ultimate purpose_ of Nature, is a defeat of her intention.
5. Such a deviation, change, or impediment may occur at any time
previously to the period established for the appearance of a new and
perfect being. If it occur at such a time as shall be incompatible with
the maturation, and consequently with the life of the new creature, or
even with its maturation alone, (although tokens of life be observed at
the time in question,) a MISCARRIAGE is said, in common parlance, to
have taken place; for Nature has _miscarried_ in her undertaking: she
has been foiled in her expectations.
6. In the reproduction of the human species, such an event might justly
be considered to have occurred, if, at any time before the completion of
the natural period of gestation, the fœtus be expelled, whether dead or
alive. But as in many instances, notwithstanding its premature
expulsion, the fœtus has grown and has continued to live its
extra-uterine life, in spite of the want of maturity, (a case known to
have occurred even so early as between the sixth and the seventh month,)
the expression, before mentioned, (5) is not applied to any untimely
expulsion of the fœtus that may take place later than that period—at
which, and after which, and till the completion of the ninth month of
gestation, such an expulsion would be called a _premature_ labour. The
distinction, however, is more specious than useful: it is an offering to
social etiquette, rather than to science.
7. The premature expulsion of the produce of conception before the
seventh month, has also received the name of ABORTION. This denomination
has been generally adopted, and is used by the writers of every
civilized nation, ancient or modern, according to their respective
languages. It is that which has been employed in the following
explanations of figures taken from nature, which are intended to exhibit
several examples of abortion in the human species.
8. The study of abortion, in this point of view, (7) is an infinite
source of interest, whether considered in reference to science and the
important question of generation, or simply in reference to medical
practice. On the continent of Europe, and even in the States of America,
but more particularly in Germany, the subject, under its two-fold
aspect, has engaged the serious attention of some of the most learned
philosophers and most skilful practitioners. I know of no other
professed writer on the same subject, besides Burns, in this country.
His work on abortion is brief, and more valuable for the practical
suggestions it contains, than for any luminous or accurate view of the
various scientific points connected with that subject. But like every
thing which proceeds from the hands of that able practitioner, the
performance is respectable.
9. It is impossible, thoroughly and accurately, to comprehend the mode
in which abortion takes place, without being previously acquainted with
the origin, formation, progress, and metamorphoses of the fœtus, and its
connection with the mother. On all these points, we have, until lately,
been in the habit of professing the same articles of belief as our
predecessors: we have repeated what we heard them say, or what we read
in their writings; and many, both here and elsewhere, repeat still the
antiquated theories respecting conception and the structure of the human
ovum, which they have learned on the obstetrical benches.
10. The great advancement—the great and forward strides which physiology
has made in France, as well as in Germany, have contributed to explode
those antiquated theories. Acute and indefatigable anatomists have been
busy watching Nature in all her movements, from the first moment of her
calling the rudiments of a human embryo into existence, until her
magnificent work has been completed by the production of a new,
life-gifted, individual of the species. They have called to their aid
the much improved art of microscopical observation, and have thereby
succeeded in almost tracing the very earliest instant of embryonic
existence. The register of their observations constitutes the biography
of the human fœtus.
11. It is with the view of contributing to the common stock of new and
interesting information on this all-important question, that I bring
forth the result of my inquiries into the morbid state of the human
Ovum, and its structure under circumstances of premature expulsion. If
such inquiries have led me to adopt the improved notions of the more
modern physiologists and anatomists in these matters (which I have
professedly studied, and have had the most ample opportunities of
studying for many years); they have, likewise, enabled me to detect some
of the oversights of those observers, and to add a little to what has
already been brought forward; while, at the same time, they have induced
me to join that class of writers who dismiss, as inconsistent with
facts, the theories and assumptions of olden times, whose strongest
authority has been their mere repetition.
12. The ideas which are now entertained respecting fecundation,
after the successful congress of the two sexes, in the human
species—respecting its seat—respecting the first origin, station,
and rudimental creation of the embryo—respecting the journey of the
latter into the womb, its sojourn in that cavity, and the various
metamorphoses it undergoes therein, up to the period fixed for its
projection into the WORLD, may be comprised within a small number of
propositions. I shall support those propositions by references to
facts, or the quotations of competent authorities, and the
allegation of anatomical discoveries. But as the object of the
present work is to illustrate abortion, and not the complete
life-circle of the fœtus, I shall stop the number of my propositions
at the _fifth_ month of its intro-uterine existence. After that
period, the various phenomena of fœtal gestation are so uniform,
that they afford less matter of interest to the philosopher.
13. CONCEPTION, or that result which follows sexual congress, in virtue
of which one, or more individuals, of the same species is called into
being, takes place in the ovarium of women. This is doubted by Meckel
and others, who look upon all cases of ovaric gestation (see Plates IX.
and X, A. and B.) as mere accidents, and as only proving that if
conception has not before taken place in the womb, it _may_ take place
in some other part connected with it; but the point has been set at rest
by the more recent experiments and microscopical observations of
Professor BOER, of Kœnigsberg. I adopt his conclusions. Their
correctness is corroborated by the interesting experiments of Prevost
and Dumas, although these experimenters admit not that fecundation takes
place in the ovarium.
14. The intended receptacle of the embryo is the OVULUM. An ovulum
exists in all the vesicles of Graaf, which the ovarium of a woman, who
has reached maturity, contains.
15. Viewed by means of a powerful microscope, the ovulum is found to
consist of a small yellow spherical body, placed within the vesicula
Graafiana, with the upper portion of which it is, internally, in
contact; so that it does not float freely in the liquid of that vesicle.
This contact becomes more and more intimate as the ovulum enlarges, when
that part of the capsule of the vesicle which lies over it becomes, in a
correspondent degree, thinner.
16. At first, the little yellow body, being rather opaque, is distinctly
seen even without a magnifying glass; but as it advances, it becomes
more transparent and, consequently, less distinguishable.
17. This little yellow body is a minute spherical mass, with a roughish
or slightly granular surface, and is hollow. Its parietes are thick;
around them is an envelope of a much thinner texture, which is
distinctly seen, owing to a small space lying between it and the surface
of the little yellow body, which space is filled with a fluid substance
of a peculiar nature.
18. When FECUNDATION takes place, that part of the vesicle of Graaf to
which adheres, internally, the ovulum, bursts, and the ovulum escapes
with its external envelope, together with a small portion of the liquid
peculiar to the Graafian vesicle, and thus it passes into the fallopian
tube.
19. Independently of the external envelope, and within it, the
microscope has detected, after fecundation, the existence of another
covering, completely investing the little spherical yellow body.
20. The ovulum has been traced, after fecundation, into the cavity of
the womb, where the external covering (17) becomes what Boer has called
“the cortical membrane”, (_cortex ovi_ of the present work,) improperly
considered as a uterine production by preceding writers, and denominated
the _reflected_ caducous or deciduous membrane.
21. The more intimate covering of the yellow body of the ovulum, that
which closely invests its surface, and appears only after fecundation,
(19) is afterwards changed into what has been denominated the shaggy
chorion: my observations and my plates shew this. Boer, however,
professes not to know what becomes of it during the progressive
intro-uterine development of the ovulum.
22. The hollow and spherical yellow body of the ovulum corresponds with
the yelk or _vitellus_ of the ovum of oviparous animals, and from it all
the other several parts of the fœtiferous ovum are derived or formed, as
gestation advances, and a progressive development of the parts takes
place, from within, without[1].
23. The existence of the cortical membrane is proved in many parts of
the present work, but particularly by Fig. 15, Plate III., and Fig. 17,
Plate IV. in both of which specimens of abortion, the said _cortex_ had
persisted to a longer period than usual during gestation, and had
become, consequently, thickened, opaque, fleshy indeed, and the cause of
abortion. Figure 15, too, shews strongly the probability of my notion
that the thin membrane investing the surface of the yellow body of the
ovulum is, in good truth, what has been usually denominated the shaggy
chorion.
24. Another proof, amounting to demonstration, of the existence of a
cortical covering to the human ovulum, and that of the filiform envelope
called the shaggy chorion within it, I find in a striking and beautiful
preparation belonging to Sir Charles Clarke, marked 87. We there see a
complete cast of the lining (caducous membrane) of the uterine cavity
after fecundation, thrown off at a very early period, and with it the
ovulum, (of the size of a Portugal grape,) exhibiting the _cortex ovi_,
shelly and membranaceous, of a dense texture, yet flexible, which has
burst like the pericardium of some seeds, and allows the shaggy chorion
beneath it to be seen. It is a curious fact, that even Ruysch has, in
his fanciful manner, represented a human ovulum of about three weeks
with the cortex burst, yet still _in situ_, and the shaggy chorion
beneath it, in every way resembling the specimen of Sir Charles Clarke’s
in the Museum of St. George’s Hospital.
25. Even the errors of some of the very able anatomists of the present
day come in beautifully to corroborate Professor Boer’s observations of
the cortical membrane. Breschet and Velpeau, for instance, state, that
within what they (with their predecessors) have looked upon as the
decidua in the human ovum, there is a cavity containing a peculiar
liquid which, in their opinion, is essential to the nutrition of the
fœtus. Now what is this but the very description of the ovulum by Boer
(17), proving that there is a cortical membrane in the human ovum?
26. The cortical membrane is destined to be absorbed during the first
months of utero-gestation, thus exposing the next membrane to the
contact of the uterine lining (decidua), with which a connection takes
place in that part where the placenta is to be formed. In that part,
however, the cortex ovi is never altogether obliterated, but only made
thinner; and, in process of time, it is converted into a mere pellicular
envelope, which not only serves to divide the filiform vessels of the
chorion into groups or cotyledons in order to form the placenta, but
also covers all over those cotyledons or groups of vessels. (Plate I.
Expl. of Fig. 1.) I have called this the _membrana propria_[2].
27. While the process or metamorphosis of the ovulum noticed by Boer
takes place in the ovarium, in consequence of fecundation, the cavity of
the womb does not remain idle, but forthwith sets about weaving for
itself a general lining—a sort of pseudo-textile membrane—which extends
all over the cavity, descends partly into the cervix, and is _often_,
(not necessarily always,) projected even into a great portion of the
fallopian tubes.
28. This adventitious lining of the cavity of the womb is formed quite
independently of the presence of the ovum, for it has been found in most
cases of devious gestation, where the fœtus was _extra muros uteri_
(Plate VIII. IX. X. Fig. 1 and 2, and page 35), and has been found
advanced in its progress of formation, while the ovulum was, as yet, on
its way through the fallopian tube after fecundation. (Haller, Lobstein,
Velpeau, Meckel, Pockels.)
29. To this adventitious lining described by many ancient authors, but
by none better than by Harvey, the name of decidua already mentioned
(24, 26) has been given by Hunter, because, viewed as a production of
the uterus it is caducous and not permanent like its own natural lining;
as, however, it is no more caducous than any other of the involucra of
the ovum, the denomination is not strictly correct. It is, nevertheless,
more generally adopted than that of epi-chorion, given to the same
pseudo-membrane by Chaussier.
30. Its mode of formation and its structure have been differently
explained by different authors. The explanation offered by Burns runs
counter to facts and realities. That author speaks of all the minute
steps of generation, with the same confidence as if all had been
demonstrated. His imaginings respecting primary and secondary vessels
shooting out from the inner surface of the womb to form the decidua must
be gratuitous, as no other anatomist or physiologist, either before or
after him, has been able to ascertain the reality of such a process.
31. It is probable that the decidua consists of two laminæ, inasmuch as
we always find it with one surface perfectly smooth and the other rough.
If so, they are most intimately connected. It is at least one-twentieth
of an inch in thickness during the first five or six weeks of
uterofœtation, when its tissue is found to be more knotty, coarse, and
full of short threads, (not unlike a very ordinary mat,) than a purely
membranaceous or cloth-like lining would be. It is not until a more
advanced period of gestation that the decidua becomes distinctly
membranaceous, in which state it lines the entire cavity of the uterus.
(Plate IX. and prep. 73, 75, 76, of Sir Charles Clarke’s Collection:
also Dr. Agar’s beautiful specimen of impregnated uterus, Mus. Coll.
Reg. Lond. Med., and several specimens in the College of Surgeons,
particularly Sir W. Blizard’s case.)[3]
32. Into this chamber, then, so lined and so prepared the fecundated
ovulum, in the condition described by Professor Boer, is received after
its journey from the ovarium through the fallopian tube.
33. The pre-existence of an ovulum in the Vesiculæ Graafianæ, or Ovarian
Vesicles—and its metamorphosis, after fecundation (14, 15, 16, 17, 18,)
have been amply confirmed by Plagge of Bentheim, who published an
account of his experiments and observations, illustrated by figures, in
Meckel’s Journal of Physiology. (See also Prevost and Dumas, 3rd
memoir.)
34. As soon as the Ovulum has departed from its vesicular nest in the
Ovarium, the cavity which remains begins to fill up with a yellow
substance, different in texture from the surrounding tissue of the
Ovarium, and having, generally, a radiated centre of a whiter colour.
This is the _corpus luteum_. (Plate IX., page 30 and 31; also, Spec.
3468 B and C, Gallery College of Surgeons, and Dr. Agar’s case Royal
College of Physicians[4].)
35. The presence of _corpora lutea_ in the Ovarium of women, is always
an indication that as many ovula have escaped from that organ; but it is
not necessarily an evidence that the individual has been impregnated, as
ovula have escaped without the congress of the two sexes.
36. It is inaccurate, therefore, to state that a woman has been pregnant
because a _corpus luteum_ has been found in one of the Ovaria after
death, or to calculate the number of children she has borne from the
number of _corpora lutea_ so detected. _Corpora lutea_ have been found
in the Ovaria of very young girls, of unmarried women of the strictest
virtue, in newly-born female infants, and lastly, in sterile animals,
such as mules. (Brugnone, Joer. Roose.)
37. Sir Everard Home’s notion that the _corpus luteum_ was formed first,
and that, too, independently of sexual congress, and that the Ovulum was
formed afterwards, is disproved by more accurate and recent observers.
(Boer, Plagge.) There is reason to believe that Sir E. Home had been too
precipitate in his inquiry[5].
38. The Ovulum, on entering the womb, is about the size of a small pea.
The cavity, on the contrary, into which it enters, from the very first,
is of considerable dimensions. One cannot help being struck at this
great disparity in the relative dimensions of the Ovulum and the cavity
of the womb. When they first come in apposition, that of the latter is
from ten to twenty times greater than that of the former. (See Sir W.
Blizard’s case, Royal College of Surgeons, and Spec. 73, 75, 76, in Sir
C. Clarke’s Collection[6].)
39. The time at which the Ovulum enters the womb after fecundation is
not precisely known. (Meckel.) The fimbriated end of the fallopian tube
has been found actually applied to a Graafian vesicle after copulation.
(Magendie.) An ovulum, containing the rudiments of an embryo has been
observed in the human subject half engaged within the tube, and half
still resting on the Ovarium. (Bussieres.) The Ovulum has been detected
on its way through the fallopian tube.—(Burns, Haighton, Cruikshank,
Prevost, Dumas.) It is said to have been detected in the uterine cavity
on the eighth day. (Home.) Although it has lately been the fashion to
doubt the accuracy of such a fact, there is reason to believe it to be
correct, from the circumstance of M. Bauer’s microscopian examination of
that Ovulum and description of its structure corresponding with more
recent discoveries. (Boer.) The embryo contained in an Ovulum of a
week’s growth has been seen and measured. (Autenrieth _Supplementa ad
Historiam Embryonis Humani_.) The Ovulum, until the eighth day, has been
observed in the uterus under a gelatinous form by another anatomist.
(Walker.) Ovula in the fallopian tubes have also been seen on the eighth
day by Prevost and Dumas.
40. I have had occasion, within the last two months, to see a perfect
Ovulum ejected from the womb fourteen days after a single sexual
congress, which had taken place the day after the cessation of the
menses. Dr. Pockels (Isis, December 1825,) examined more than fifty
human Ova, among whom four had been expelled from the womb between the
eighth and sixteenth day after conception. On the fourteenth day the
Ovulum is about the size of a Spanish nut. The chorion is surrounded by
a thick membrane[7].
41. An Ovulum at three weeks is mentioned by Hunter (Gravid Uterus). At
twenty-two days a perfect Ovulum, with the embryo clearly defined, was
shewn by Dr. Combe to Dr. Baillie. Blumenbach asserts seeing an Ovulum
of the size of a small cherry, which could not have had more than
twenty-three days’ existence. M. Ogle’s case, published in the
“Transactions of the Society for the Improvement of Medical and Surgical
Knowledge”, was one of an Ovulum in Utero at five weeks. These facts
contradict Burns’ assertion, that at “three weeks or a month after
impregnation no fœtus is in the uterus.”
42. After being safely lodged within the cavity of the womb, the Ovulum
continues to grow on its own life-principle, for a while, until its
connection with the mother is effected, through the medium of the
deciduous membrane, which becomes, at a more advanced period, as it
were, a new and additional covering to the Ovulum. The growth of the
Ovulum causes the _cortex_ to burst, as happens with the receptacle or
cortex of certain seeds, and with the outer shell of the ova of some
oviparous animals. (See Plate I., fig. 1, 2, 3, 4.)
43. On the cortex bursting, the lanuginous or fibrillous membrane within
it (21) is exposed, when the fibrils will forthwith entwine themselves
with the flocculi of the decidua, and thus the Ovulum fastens itself to
the uterus by one or more contiguous points. (Carus.)
44. The membrane having these fibrils on its surface, has been called
the Chorion—and from the circumstance that these fibrils, both before
the cortex which lies over them has burst, as well as afterwards, serve
to promote the nourishment of the fœtus, I have styled it, the nutritive
membrane or involucrum of the fœtus. It has been so considered by
Ruysch, who calls the villous side of the Chorion, “_succosa nutritioni
fœtus inserviens_.”
45. The fibrils of the Chorion have generally been considered as
filiform vessels. When examined with the microscope, they appear
diaphanous and ramiform; some of them terminate into little bulbs like
the ampullæ of the villosities of the intestines. These bulbs adhere so
firmly to the cortex ovi, that when an attempt is made to detach them,
many are lacerated. (Carus.) It is only when the cortex bursts of its
own accord that they are set at liberty. (43.)
46. These fibrils, however, are not all vessels. Some are only suckers,
others are real vessels. (Carus.) The existence of any vessels among the
fibrils of the Chorion has been denied very recently upon the same
ground, namely, microscopical observations. (Breschet and Raspail.) But
there must be an evident mistake in such observations; for the actual
progress of those filiform vessels, and their gradual swelling into
large veins and arteries, at an advanced period of fœtation, have been
noticed in examining various human ova of different ages. (Lobstein,
Velpeau, Dutrochet, and myself.)
47. The nutritive envelope or involucrum, or membrane (Chorion) of the
Ovum is bifoliated. I have a beautiful preparation of the transparent
membranes of the Ovum, even after regular parturition, which proves this
fact. It is probably even trifoliated. (Dutrochet.) A fluid has been
found between the two laminæ of the Chorion. (Meckel.)
48. The internal surface of the Chorion is likewise supplied with
fibrils, which connect it with the next and innermost involucrum of the
fœtus, called the Amnion. Between the fibrils or filiform vessels of the
two surfaces, a communication is kept up by small vascular trunks which
meander between the two laminæ of the Chorion. (Meckel and myself.)
49. The vascularity of the Chorion is further proved by its diseases,
chiefly of an inflammatory character, ending in the thickening of its
texture. (Plate III., page 12—Plate IV., page 13—Plate V., page 17—and
many other examples in this Work.) There is a preparation in Sir Charles
Clarke’s collection which shews the vessels of the Chorion as evidently
as if they were injected.
50. But the vascularity of the transparent membranes is proved further
by fine injections thrown into the vessels of the ovaria of women; on
which occasion a beautiful net-work of minute vessels is rendered
manifest, forming a species of vascular ring around the _Vesiculæ
Graafianæ_. The same observation has been made by comparative
anatomists. (Cuvier, Home, Lobstein.)
51. These facts, demonstrative and corroborative of the vascularity of
the Chorion, (45, 46, 48, 49,) explain and account for the reality of
that self-existing life-principle inherent in the fecundated Ovum (42),
which detaches it from its nest (vesicula Graafiana), enables it to
travel through the tube, to grow or expand while thus travelling, and to
maintain that same power of growth and development for a short time
after its reception into the womb, until its final and effectual
implantation on the maternal stock (uterus).
52. The same holds good with regard to the amnion, or inner transparent
membrane of the Ovum, which, although normal anatomy has failed, morbid
anatomy has succeeded in proving to be vascular. (Plate VI. fig. 20, and
Description, p. 19, and Remarks, pp. 20–24.) (Haller, Monro, Chaussier,
Meckel.)
53. If it be true that the amnion is a vascular membrane, there is no
difficulty in viewing it also as a secreting membrane. Hence the source
of that particular fluid, to which the name of Liquor Amnii has been
given, and in which the embryo is suspended to the end of gestation.
(Plate I. fig. 4, but particularly fig. 7, 8, and 9, and Remarks.)
54. The amnion is a sac formed by the reflected epidermis of the embryo.
(Velpeau, Boer, Pockels.) It does not exist before the twelfth day.
(Velpeau.) At the eighteenth day it is found as a bladder placed on the
back of the embryo, and continuous to it along its edges or sides and at
its extremities. (Velpeau.) It has been distinctly seen on the twelfth
day. (Pockels.) It is then not a concentric membrane within the chorion,
but a vesicle, on the outside of which the embryo rests as on a bed.
Until the day in question the embryo is connected to the vesicular
amnion at the back, by a cellular transparent membrane. From that time
till the sixteenth day the embryo progressively gets into the cavity of
the amnion, which before was connected with the chorion by one of its
piriform extremities, while the other conical extremity penetrates
slowly into the albuminous fluid of the chorion. (Pockels.)
55. While the embryo is within the chorion (nutritive involucrum) and
rests on the vesicular amnion, the former membrane, or sac, contains a
reddish transparent fluid having the consistency of the albumen of an
egg, (54.) with a colourless and very slender membrane crossing it in
various directions. (Pockels.)
56. The progressive increase of the Ovulum, from the time of its
quitting the Ovarium until it has stationed itself firmly within the
womb, has been demonstrated (Magendie, Prevost). In examining, between
eight and twelve days after fecundation, the female organs of such of
the mammalia as are multiparous at a single gestation, one Ovulum has
been found near the fimbriated end of the fallopian tube of one size; a
little farther into the tube another of a larger size; and lastly, near
to the uterine orifice of the tube, a third of a still larger size;
shewing the relative progressive increase that had taken place in such
Ovula subsequently to a single act of fecundation, and proportionate to
the time employed by such Ovula in travelling to the spot in which they
were found. (Prevost, and Dumas’s 3rd Memoir on Generation.)
57. While thus circumstanced, the Ovulum is never connected with the
part through which it passes. On plunging that part into water, the
Ovulum is found not only to rise to the surface, but to float. (Home,
Prevost, Dumas.)
58. What stronger proofs need be required of the existence of an
inherent life-principle in the Ovulum, which is, at one time at least,
(indeed I suspect throughout the period of gestation,) independent of
any connection with the parent mother? (Plate I., and several of the
explanations of figures throughout the work.) Yet none of the earlier
writers who adopted the Ovarian theory of generation have ever asked
themselves this question: What supports the vitality of a fecundated
Ovulum after it has left the Ovarium, and previously to its becoming
connected with the womb? In fact, the subject had never been mooted,
before the more modern physiologists took it up and satisfactorily
explained it[8].