620 



UTERUS AND ITS APPENDAGES. 



animation it is very possible that a part of 

 the fluid was contained in the ovary, for a 

 concomitant enlargement of both tube and 

 ovary is a very common occurrence, as in the 

 case represented in Jig. 422. ; and on this 

 account no record of any very considerable 

 dropsy of the Fallopian tube should be con- 

 sidered as complete, unless the condition of 

 the corresponding ovary is also mentioned. 



Collections of puriform fluid in the tube. 

 Abscess of the tube. The presence of pus in 

 the Fallopian tube is most frequently asso- 

 ciated with suppurative puerperal inflammation 

 of the uterus and its appendages generally. 

 But it may also occur independently of the 

 puerperal state, and as a consequence of ca- 

 tarrhal inflammation of the mucous lining of 

 the tube which may have passed into the sup- 

 purative stage. These cases differ from the 

 foregoing, not only in the nature of the con- 

 tents of the tube, consisting here of pus or of 

 puriform fluids with admixture of other in- 

 flammatory products from the lining membrane 

 of the tube ; but also in respect of the great 

 tendency which is here observable to the for- 

 mation of adhesions and the establishment of 

 fistulous openings into adjacent parts, as into 

 the bladder, intestines, or peritoneum, into 

 which cavities these fluids are occasionally 

 discharged. 



Cysts containing fluid attached to the tube. 

 Very commonly there may be observed one 

 or more cysts containing a small quantity of 

 transparent fluid, attached by a narrow pe- 

 duncle to the tube, and particularly to the distal 

 extremity (fig. 368. <=>). The nature of these 

 cysts has been already explained. (See p. 597.) 

 They can only be regarded as morbid when 

 they attain to an unusual size, as in fig. 421. 

 They are occasionally found as large as a nut, 

 but they very seldom exceed, and indeed do 

 not often attain even to this size. 



fibrous tumours. One of the most re- 

 markable points of difference between the 

 morbid conditions of the Fallopian tube and 

 of the uterus respectively is the very great 

 rarity of the occurrence in the former of those 

 fibroid growths, which in the latter constitute 

 its most common abnormal peculiarity. No- 

 thing can mark more distinctly the difference 

 of texture between these two parts than this 

 very characteristic circumstance : since it is 

 now known that the peculiar fibrous tumour 

 of the uterus is formed at the expense of the 

 natural tissues of that part. Occasionally, 

 indeed, small fibrous tumours are found in 

 the parenchyma of the tube, but these never 

 attain to any considerable size. These oc- 

 casionally undergo calcification, from a deposit 

 of earthy material in their texture, and thus 

 form little masses of stony hardness which 

 project from the walls of the tube, and are 

 covered by its peritoneal coat. 



Tubercle is occasionally formed in the Fal- 

 lopian tube. It occurs there usually in the 

 form of tuberculous infiltration, which, iu the 

 opinion of Rokitansky, affects chiefly the 

 mucous membrane of the tube. The occur- 

 rence of tubercle here presents nothing re- 



markable enough to call for further special 

 description. 



Cancer of the tube is not a common oc- 

 currence. I have never met with it inde- 

 pendently of cancer of the ovaries or uterus ; 

 but when either of the latter organs are exten- 

 sively affected, the tubes are also occasionally 

 involved. Upon the malignant diseases of the 

 Fallopian tube most pathological writers are 

 nearly silent ; nor has our literature been 

 enriched by any considerable number of special 

 records bearing upon this point in Pathology. 



Rupture of the Fallopian tube. Spontaneous 

 laceration of the walls of the tube occurs 

 sometimes as a result of over-distension, or 

 too great attenuation of its tissues, whereby 

 the parietes are rendered no longer capable of 

 resisting the increasing pressure of the fluids 

 accumulated within. In this way large col- 

 lections of serous, purulent, or sanguineous 

 fluids are sometimes poured out into the 

 cavity of the abdomen, unless, indeed, by the 

 previous adhesion of the walls of the tube 

 to surrounding parts, the point of rupture is 

 directed to some neighbouring hollow viscus 

 by which the fluids escape externally. But 

 rupture of the tubes will most frequently 

 happen in connexion with the tubal form of 

 extra-uterine gestation, which is next to be 

 described. 



Detention and abnormal Development of the 

 Ovum in the Oviduct. Tubal Gestation. Gra- 

 viditas tubaria. This constitutes a second 

 species of those aberrant forms of gestation, 

 commonly termed extra-uterine, one of which 

 has been considered under the title of Ovarian 

 Gestation, (p. 586.) 



It has been already shown, that one prin- 

 cipal office of the Fallopian tube is the con- 

 veyance of the ovum from the ovary, or place 

 of its first formation, to the uterus, or seat of 

 its final development ; and that the ovum, 

 whilst in transitu, not only becomes impreg- 

 nated, but also exhibits certain indisputable 

 evidences of commencing development, which, 

 however, has usually advanced only a few 

 stages by the time that the ovum enters the 

 uterine cavity. The tube, therefore, as well 

 as being an oviduct, is also the seat of normal 

 impregnation ; whilst, in addition, it serves to 

 protect and possibly, in some slight degree, to 

 add to the material of the ovum, although the 

 actual operation of the tube walls upon the 

 surface of the ovum in this respect must ne- 

 cessarily be very slight in the mammalia, since 

 it so rarely happens that any increase in its 

 size is perceptible from the time of its quitting 

 the ovary to that of its reaching the uterus. 



But the impregnated ovum, instead of en- 

 tering the uterine cavity, may be accidentally 

 detained in the tube, and undergo further de- 

 velopment there. The extent to which this 

 development may proceed will depend in a 

 great measure upon the capability of expansion 

 of the tube walls ; a circumstance which 

 seems to vary greatly in different individuals, 

 and also in some degree according to the 

 portion of tube which the ovum occupies. 



The differences observable in this latter 



