The Ethics of Medical Homicide and MutilationO'Malley, Austin
Religion
The Ethics of Medical Homicide and Mutilation
O'Malley, Austin
Medical ethics
the others, and it forms a shallow gutter which extends to the ovary.
The uterus, tubes, and ovaries lie in a septum which reaches across
the pelvis from hip to hip. This septum is called the Broad Ligament.
If a man's soft hat, of the style called "Fedora," is inverted, the
fold along the crown coming up into the cavity of the hat is like the
broad ligament. As the crown is held downward the uterus would be in
the middle, its fundus upward, and outside the hat, representing the
pelvic cavity, but in the crown fold. The tubes and ovaries would
also be in the crown fold, or broad ligament, and the fimbriated
extremities would open into the interior of the pelvic cavity through
holes. The ovum breaks through the surface of the ovary into the
pelvic cavity, passes, probably on a capillary layer of fluid, into
the fimbria ovarica and thence into the infundibulum, whence it moves
along slowly into the uterus.
Ovulation and menstruation occur about the same time ordinarily, and
if the ovum produced is not fecundated it gradually shrivels and
passes off through the uterus and vagina. Fecundation of the ovum
rarely occurs in the uterus, but ordinarily in the Fallopian tube.
After fecundation the ovum is pushed on through the Fallopian tube
into the uterus in from five to seven days, where it fastens to the
wall and develops normally. Hyrtl described an ovum which appeared
to reach the uterus in three days. If from some abnormal condition
of the Fallopian tube the fecundated ovum is blocked and held in the
tube, the embryo grows where the ovum stopped, and we have a case
of Ectopic Gestation. In normal pregnancy in the uterus, the uterus
grows with the embryo, but a tube does not. In the latter condition,
when the ovum is big enough it bursts the tube or slips out through
the ampulla, causing hemorrhage or other pathological symptoms.
There are certain rare abnormalities of the uterus through imperfect
embryological development, and pregnancy in such a uterus may result
in symptoms like those of ectopic gestation. Normally the uterus and
vagina are formed by the fusion of the two Müllerian ducts. When
these ducts do not fuse perfectly, or when one develops partly, the
various kinds of abnormal wombs and vaginas are the results. There
may be a double uterus with a single or double vagina, a uterus with
a complete or partial septum down the middle, a uterus with one
horn, a uterus with a developed horn and a rudimentary horn, and the
rudimentary horn may be open or shut, and so on. In many of these
conditions the ovum becomes blocked and rupture follows as in ectopic
gestation.
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