Observations on Abortion: Containing an account of the manner in which it is accomplished, the causes which produced it, and the method of preventing or treating itBurns, John
Science
Observations on Abortion: Containing an account of the manner in which it is accomplished, the causes which produced it, and the method of preventing or treating it
Burns, John
Miscarriage
The primary vessels adhere pretty closely together at their roots, but
are more loose or separated at their termination. They are at first only
yielded by the fundus, and in a small degree by the surface, immediately
above the cervix, whilst the cervix itself produces from the lacunæ,
which are increased in magnitude, a jelly, which sometimes fills up the
os uteri completely; at other times there is only a small quantity
formed in the cervix, leaving the os uteri quite patent. The inferior
part of the uterine surface, which yields the primary vessels, is not a
quarter of an inch in breadth; and the cavity being there small and
narrow, the vessels from the opposite sides soon come in contact, and
intermix without forming any secondary vessels. This portion may be
called the cervical efflorescence.
The secondary vessels are very different from the primary; for, whilst
the latter are short, straight, and parallel to each other, the former
are more extended, intermix, and ramify together, so as to form an
irregular tissue or sheet of vascular substance, the fibres or vessels
of which assume a direction at right angles to the down or primary
vessels which formed them. This direction seems to be very naturally
produced by the weight of the secondary vessels, which makes them hang
down or point to the os uteri. Very soon we can perceive ragged
irregular processes, hanging into the cavity of the uterus, and
extending toward the cervix, so that this layer of decidua presently
appears to consist of a number of torn floating membranes, like portions
of spiders’ webs, pendulous in the uterine cavity; but nearer
examination shows that there has been no laceration, the margins being
smooth and well defined. These I would call the processes of the decidua
interna.
Such is the structure of the decidua externa and interna, at three weeks
or a month after impregnation; and at this period no fœtus is in the
uterus. In one case I detected the vesicular ovum in the tube. It was
about half way betwixt the two extremities, was rather smaller than a
full-grown pea, and contained a little fluid. In another case I found it
still in the ovarium, covered by the fimbriated extremity of the tube.
By puncturing the peritoneal coat of the gland, the vesicle escaped.
It has been the general opinion, since the time of Dr. Hunter, that the
decidua extended a little way into the tube; and on his authority I
stated this to be the case in an account which I formerly published. By
careful examination, I am now convinced that this is not the case. My
brother, in his dissections, even thought that the uterine extremity of
the tube was less changed in point of vascularity, than any other part
of it.
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