FALLOPIAN TUBE OR OVIDUCT (ABNORMAL ANATOMY). 



curring in the acute or chronic form, the 

 fluid, secreted more abundantly than in a 

 state of health, may find vent by either or 

 both of the tubal orifices, so long as these re- 

 main pervious. 



It is probable that in this affection the 

 superabundant fluid flows generally by the 

 lower orifice into the uterus, and so escapes 

 per vaginam, constituting one of the numer- 

 ous forms of " leucorrhrea." But if both ex- 

 tremities of the tube are closed, then, as in 

 the case of haemorrhage or menstruation oc- 

 curring under like circumstances, the fluid 

 collects within the tube and mechanically 

 distends its walls. 



619 



The pressure producing this distension, 

 when operating in only a slight degree, causes 

 a nearly equable enlargement of the tube, so 

 that its natural conical shape is still preserved. 

 But as the quantity of fluid increases, the thin- 

 ner and less resisting portions of the walls, 

 which lie towards the distal extremity, give 

 way more rapidly than those at the proximal 

 end ; and the tube, after becoming irregularly 

 tortuous, is at length converted into a series 

 of sacculi, the largest of which, usually of a 

 pyriform shape, occupies the extremity of the 

 tube (fig. 422. d). 



From the irregularity with which different 

 portions of the tube walls dilate under the 



rig. 422. 



Distension of the Fallopian tubes, with obliteration of both orifices. (After Hooper.') 

 a, uterus ; b, vagina ; c, os uteri j d and/, Fallopian tubes ; e, ovary. 



pressure of the accumulated fluid, it often 

 happens that several angles are formed by the 

 sudden bending of the parietes, and at these 

 points the tube walls, extending inwards, con- 

 stitute so many valvular projections which 

 partition the tube into several irregular cham- 

 bers, communicating together by narrow ori- 

 fices. Such a condition of parts may be 

 frequently observed upon both sides of the 

 body, as in Jig. 422., where both tubes are 

 affected in the same manner although in un- 

 equal degrees. 



When these dilatations have attained to any 

 considerable size the condition of the lining 

 membrane of the tube becomes altered, so 

 that the mucous gradually acquires the cha- 

 racter of a serous surface, and the fluids 

 collected within these sacculi present the 

 ordinary condition of the fluids of serous 

 dropsies. 



The more simple of these fluids are thin, 

 serous, and nearly colourless, and may be 

 more or less albuminous. Not infrequently, 

 however, they contain flocculi, or are thick- 

 ened by the admixture of various yellow, 

 brown, or chocolate coloured denser fluids, 

 consisting chiefly of pus and disintegrated 

 blood. 



The quantity of fluid does not commonly 

 exceed a few drachms, and in ordinary ex- 

 perience six or eight ounces would be a rather 

 large accumulation. Yet it is certain that 

 sometimes a much more considerable collec- 

 tion has been observed. 



Thus in " Bonnet's Sepulchretum Anato- 

 micum*," a case is given in which one of the 

 tubes held thirteen pounds of fluid ; and De 

 Haenf mentions an instance in which the 

 hypertrophied tube weighed seven pounds, 

 while the quantity of fluid contained in it 

 amounted to thirty-two pints. 



Other cases, of more or less authority, have 

 been recorded, in which the collection of fluid 

 has been estimated at 112, 140 and 150 Ibs. 

 But it is exceedingly doubtful if the tube 

 walls are capable of dilating to the extent 

 that would be necessary to support so large 

 an amount of fluid without laceration. For 

 it is very well known that in tubal pregnancy 

 rupture of the tube almost always occurs 

 before the middle period of gestation is 

 reached ; and even in those cases where the 

 reports are founded upon post-mortem ex_ 



* Lib. III. Sect. XXI. Obs. 39. 

 f Rat. Med. Tom. III. p. 29. 



