The diseases which affect the Fallopian tubes are inflammation,
stricture, distention and displacements.
The inflammation is distinguished as salpingitis, from _salpinx_,
Fallopian tube, and _itis_, in composition, inflammation; this consists
of a catarrhal inflammation of the lining membrane of the tubes, which
rarely if ever originates in the tubes themselves, but is secondary to
an inflammatory process in the neighboring organs.
Chronic endometritis or catarrh of the womb is undoubtedly the most
fruitful cause of salpingitis, although this is not absolutely the
rule, for there are some women who have had uterine catarrh for years
without its affecting the tubes in the least. But there is a type
of uterine catarrh that has a special tendency to spread from the
womb to the lining membrane of the tubes, and this is the infectious
endometritis. An infectious inflammation of the womb may be due to many
different sources of infection; the retained products of conception
after an abortion may become putrescent and furnish one source;
carrying putrefactive germs into the uterine cavity from the vaginal
canal by means of probes or instruments, that are in themselves
defiled by not having been thoroughly cleansed and purified since their
last employment, is another source of infection; the latter is perhaps
the commoner cause of blood poisoning in criminal abortions by the
abortionists. Gonorrhœal infection seems to have a greater tendency
than any other to spread itself from the uterus to the tubes; this has
been the subject of special inquiry, and has been thoroughly confirmed,
and this may arise many months after the infected male has imagined
himself entirely cured.
The diseases of the tubes that I have enumerated are in the relation
of cause and effect; a catarrhal inflammation is quite likely to
induce a stricture or an occlusion, and this causes a distention from
retention of the secretions, whether the secretions are a natural or
an inflammatory product. If the inflammation has an infectious origin,
then the retained secretion becomes purulent, or it may be a muco-pus
secretion from the commencement. The dilated tube may also contain
blood or serum; the latter constitutes tubal dropsy; or it may contain
a fertilized ovum; this gives rise to tubal pregnancy.
Tubal dropsy may be a distention of the tubes when both ends are sealed
by inflammatory adhesions; these distentions vary in size from the
thickness of a finger to a large ovarian tumor, from which it is not an
easy matter to distinguish it.
The most dangerous form of tubal obstruction and distention is where
the contents are pus or purulent matter; this is liable to be poured
into the peritoneal cavity from ulceration or rupture of the sac, and
excites fatal peritonitis.
Salpingitis can only be viewed as a complication of some prior
inflammatory process in some of the adjacent organs and tissues;
these are the uterus and ovaries and the pelvic peritoneum and pelvic
cellular tissue.