ABNORMAL ANATOMY OF TI1E FALLOPIA1V TUBE.
Defect and Imperfect Development. — Ab sence of the Fallopian tube is of infrequent occurrence, and is usually observed in cases where there is a coincident deficiency of the uterus or ovary.* But when the two latter * Meckel, Handbuch der Patbolog. Anatomie, B. I.
organs are perfectly formed it is exceedingly rare to find a deficiency of the oviduct.
The oviduct may be deficient either upon one or both sides. lleusinger* has recorded an example of deficiency of the ovary and Fallopian tube of one side.
Chaussier t met with a remarkable ex ample of a woman who, notwithstanding the absence of one ovary and tube, and even of one side of the uterus, bore ten living children ; and whose death shortly after her last con finement afforded him the opportunity of ascertaining this peculiar condition of the parts.
After the observations which have been made regarding the function of the Fallopian tube, it is hardly necessary to observe here that deficiency of both tubes will be neces sarily productive of permanent sterility ; al though absence of the tube of one side, as in the case of Chaussier, just quoted, need not entail any such consequence.
Unusual shortness of the tube and the absence of the fimbrim have been also ac counted as causes of sterility ; but the former, if associated with a very short lig,amentum ovarii, would have no such effect, and could be only accounted a relative deformity when the ovary is placed at an unusual distance from the uterus, so as to be beyond the grasp of the infundibulum ; while the latter pecu liarity, as already shown, may be merely the result of age.
Peculiarities of Construction.— Several Pa rilions on the same Tube.— M. Richard, to whose researches regarding the Fallopian tube reference has been already made, has pointed out a previously unobserved condition of this part. In examining the appendages of the uterus in thirty women, he met with no less than five examples of this singular formation, which he thus describes : " At a distance varying from several millime tres to 2 or 3 centimetres behind the normal pavilion, are observed upon the course of the tube one or more accessory pavilions, formed like that which terminates the oviduct, of a mucous membrane divided into fimbrim.
When the fringes of this pavilion are floated under water, they are observed to be pierced by an aperture leading into the canal of the tube; and a probe introduced into this orifice may be made to escape either by the ostium abdominale, or by the ostium uterinum, ac cording to the direction in which it is passed. Thus, then, the canal of the tube can, in certain cases, open into the cavity of the peritoneum by- several distinct orifices." The first of M. Richard's c,ases occurred in an adult, and is represented in fag. 408.
" There is a normal pavilion of somewhat irregular form, and below it, at several milli metres distance, a small opening, surrounded by two small fringes, covered on their inner sur face by mucous rnembrane ; while the serous membrane terminates abruptly on their outer surface as in the true pavilion. A probe introduced escapes by one or other orifice indiscriminately." The second example (fig. 418.) occurred in a fcetus at term. The tube of the left side terminates in a single pavilion, but that of the right, besides its terminal pavilion, ex hibits also two little secondary pavilions, com municating each by a special orifice with the canal of the tube.
But the most interesting example is that shown in fig. 419. from a woman who aborted at the sixth month. The terminal pavilion, represented here of the natural size, exhibits a richness of fringes and folds rarely seen.
Below this large pavilion is another, the fringes of which are large and floating. This abnormal pavilion exhibits two orifices se parated from each other by a valve, which, being prolonged into the canal of the tube, interrupts all communication between that part of the canal placed above and that below it. The valve is formed of a fold of mucous membrane. A probe introduced by the ab dominal orifice of the tube escapes by one of the two orifices of the supernumerary pa vilion, whilst one passed from the uterus appears at ttie other orifice of the same accessory pavilion.