OVARY (ABNORMAL ANATOMY). 



It is not necessary to multiply these ex- 

 amples, for no additional points of evidence 

 could be produced which are not contained 

 in the foregoing cases. They have been 

 selected from instances related or quoted by 

 various authors who have been strongest in 

 their advocacy of the doctrine of ~H strict 

 ovarian gestation, and they serve to exhibit 

 the kind of evidence upon which that doctrine 

 is founded. All the cases which have been 

 employed to support this view* will be found 

 on examination to belong to one or other of 

 the following divisions : 



1. Cases of cysts without any embryo, and 

 in which some supposed resemblance has been 

 traced between the cyst walls and foetal mem- 

 branes, without any conclusive evidence of the 

 presence of these structures being given. 



riau cvst. The walls of the sac showed no separa- 

 tion into distinct membranes, and no trace whatever 

 of the structures characteristic of either chorion, 

 chorion-villi, amnion, or decidua could be discovered 

 in them. 



The outer surface of the cyst was so firmly ad- 

 herent to the surrounding ovarian stroma that it 

 could only be separated from it by considerable 

 traction. "The connecting medium was the common 

 stroma of the ovary. The walls of the cyst, when 

 Y>ortions were examined by transmitted light, ex- 

 hibited the arrangement of vessels peculiar to ova- 

 rian cysts. The little slender depending fragment, 

 supposed to be a rudimental umbilical cord, and 

 very faithfully represented by Dr. Granville in Plate 

 VIII. of the work quoted in the text, proved to be 

 a narrow flap of the same cyst wall which had been 

 left hanging from the edge "of the sac where a por- 

 tion had evidently been originally cut away in order 

 more fully to display the preparation (the sharp 

 edge left here by the knife or scissors being very 

 distinctly seen). Upon transverse section of this 

 little fragment, no trace of umbilical vessels could 

 be found in it. ' 



It should be observed that Sir Charles Clarke 

 never published an account of this case. 



The additional particulars which I am enabled to 

 give with regard to the last of the four cases quoted 

 in the text, and described in the Transactions of the 

 Royal College of Physicians for 1820, are of another 

 kind. That this preparation was formerly preserved 

 in the anatomical museum of St. Bartholomew's 

 Hospital, where the author of the case was also the 

 lecturer on anatomy, can scarcely be doubted, from 

 the description, exactly according with it, which 

 appears in the first edition of the Catalogue drawn 

 up by Mr. Stanley. (See Description of the Pre- 

 parations contained in the Museum of St. Bartho- 

 lomew's Hospital, 1831. Edited by Edward Stanley, 

 Esq. Preparation 64, series xx. p. 27.) This pre- 

 paration is no longer contained in the museum ; and 

 by those who are most likely to be informed upon 

 the subject, it is not known to be in existence. The 

 only clue that I can obtain as to its fate is derived 

 from Mr. Paget, who informs me that, as a step pre- 

 liminary to the formation of the new catalogue, 

 printed in two volumes in 1846-51, the entire ana- 

 tomical collection was carefully reexamined; and 

 that those preparations which" were found, upon 

 such examination, not to bear out the descriptions 

 given of them in the catalogue, or which did not 

 serve to illustrate any point of interest, were put 

 aside and condemned. There is, therefore, every 

 probability that this preparation, which can now 

 no longer be appealed to in support of the possibility 

 of ovarian gestation, has been subjected to a similar 

 ordeal to the former, and with a like result. 



589 



2. Cases of dermoid cysts containing fat, 

 hair, teeth, and bones, the nature and origin 

 of which, independent of pregnancy, have 

 been already considered. 



3. Cases in which the evidence is more or 

 less complete that a foetus is or has been con- 

 tained in a cavity of, or connected with the 

 ovary. 



Of the latter, as already stated, those 

 alone suffice for examination in which the 

 cyst has continued unattached to surrounding 

 parts, and has remained unaffected by dis- 

 integrating and destructive processes. In 

 this category would still be found, in all pro- 

 bability, a sufficient number of cases amply 

 to have determined the question in dispute, 

 if such methods of investigation had been 

 pursued as the present state of anatomical 

 and physiological science demands for the 

 settlement of doubtful points ; for in a 

 considerable number of cases it is rendered 

 evident that the foetus is contained within 

 a sac in some way connected with or occu- 

 pying more or less the usual seat of the 

 ovary. Here, therefore, the question is re- 

 duced to very narrow limits, Are these sacs 

 formed within and at the expense of the 

 proper ovarian structures, or are they adven- 

 titious cysts growing externally to, although 

 connected with these structures?* If strictly 

 within the ovary, and formed of it or of its 

 parts, then ovarian gestation in the strict 

 sense obtains. But this has not yet been 

 anatomically demonstrated in such a manner 

 as to set all objections at rest; for neither 

 have the blood-vessels been injected in order 

 to ascertain their new relations and distri- 

 bution, nor have the tissues been micro- 

 scopically examined, without which exami- 

 nation it would be hardly possible to determine 

 of what parts the foetus-bearing sac is com- 

 posed. Nor have the exact limits of the 

 serous and albuginean coats, nor the relations 

 of the sac to the remaining ovarian tissues, 

 nor the precise mode of connection of the 

 foetal membranes with the sac, been accurately 

 traced. Nor has the condition of the yellow 

 or corpus luteum coat of the follicle, of which 

 brief mention only is made in one instance, 

 been carefully examined ; yet this is a point 

 of the greatest interest and importance, be- 

 cause, if true ovarian gestation ever occurs, 

 then the yellow ovisac would become the 

 decidua, and the outer fibrous coat of the 

 follicle, together with the ovarian tunics and 

 stroma, would be theutertis of the ovum. But 

 in the present state of our knowledge it can- 

 not be said that the subject of ovarian ges- 

 tation stands in any other position than that 

 of an open question, the chief points of in- 

 terest regarding which may be thus stated : 



The unimpregnated ovum is known to quit 

 the ripe Graafian follicle by passing through 

 an aperture spontaneously made in the walls 

 of the follicle and of the ovary, in order to 

 enter the Fallopian tube and uterus, in one 

 of which canals it is afterwards impregnated. 



* A large collection is contained in the work of * It is thought by Boehmer that these cases 

 Dr. Campbell just cited. might be divided into external and internal. 



