M. Richard points out a very important influence which these abnormal openings may have upon the functions of the oviduct. An ovum having entered the terminal pavilion, if while endeavouring to gain the uterus it is directed along the wall of the canal which is opposite to the accidental opening, it will reach the uterine cavity ; but if, instead of coursing along the wall opposite to the so lution of continuity, it descends along this wall itself, then it will almost inevitably escape by this abnormal orifice, and will fall into the peritoneal cavity. Now, if this ovum has not been fertilised, nothing remarkable will ensue upon its escape into the peritoneum ; but if the contrary, then it is possible that the fertilised ovum having escaped from the canal which should conduct it to the uterus will give rise to an abdominal pregnancy.
Displacement of the Fallopian Tuhe.—This is, perhaps, one of those conditions of parts which would be the least likely to be detected during life, and it may on that account have been often overlooked. It is of necessity associated with displacements of certain other organs, whenever such displacements occur ; as, for example, with prolapsus inversion and retroversion of the uterus. In extreme pro lapsus or procidentia uteri the tubes, along with the ovaries, are carried down and occupy a position on either side of the prolapsed organ, and between it and the walls of the inverted vagina, while in inversion the tubes are contained in the pouch formed by the reversed uterus.* In this latter case the rela tive situation of all the parts is so altered that the uterine orifices of the Fallopian tubes may be sometimes discovered as forming oblique openings in the upper part of the va gina.t But displacement of the Fallopian tube may occur alone, and constitute a true her nia. Such an occurrence is recorded by M. A. Berard.$ In this case the displacement took the form of a crural hernia, which was at first reducible, but after gradually increasing in size it could be no longer reduced. As fluid was distinguishable within the hernial sac a puncture was made, but peritonitis ensued, followed by death; and upon exami nation it was found that the sac contained nothing but the hypertrophied Fallopian tube.
Meissner4 has collected three other cases, of hernia of the tube, one of which was con-, genital. These are all instances of incminal hernia of the tube. In the "Journn fiir, Geburtshelfer " an instance of displacement of another kind is recorded. The left Fal lopian tube had escaped through a rent in the walls of the vagina near the os uteri, and. descended as far as the labia, so that the filn brim could be easily distinguished during life.
The most common displacements of the Fallopian tubes are those which result from adhesions consequent upon inflammation of their peritoneal coat. Such adhesions con
stituted by bands or extensive surfaces of false membrane, tie down the tubes to surrounding parts, and in most instances effectually pre vent the performance of their proper func tions ; as where the tubes are adherent to the uterus, the sides of the pelvis, or the bladder or intestines. But the union is most com monly found to have taken place between the extremity of the tube and some part of the surface of the ovary, so that these are inseparably united together (fig. 400.),and very frequently in some abnormal position (jig. 420.) Obliteration of the Fallopian Tube. — In advanced life a natural contraction of the tube takes place, and the fimbrim also di minish and lose their luxuriance of form ; but it frequently happens that, independently of these natural changes, and even at an early period of life, the tubes are found nearly or entirely obliterated. Such obliteration may be occasioned by tumefiiction of the linino. membrane of the tube, or by a collection o'sf inspissated mucus in some part of the canal ; or the entire calibre of the tube may be ob-, literated by cellular formation (atresia tubm).
Occasionally calcareous concretions have been found obstructing the tube ; and the same result has been produced by growths of a malignant kind.
The occlusion, however, is generally' con fined to the abdominal end of the tube. In these cases, usually, the fimbrim are destroyed, the opening into the abdomen is completely closed, and the tube ends in a blunt cul-de sac. Such a condition of parts is generally associated with an enlarged and tortuous state of the tube, the walls of which are usually thickened, and its canal filled with fluid. In such cases the obliterated end of the tube may remain free and unattached, but it is far more often found united inseparably.to the ovary. This junction of the tube with the ovary by artificial adhesion is the most com mon of all the morbid conditions of the ovi duct. It has been supposed by some to be the result of certain libidinous habits and practices; but this conjecture is not supported by any statistical evidence. The explanation given by Rokitansky, that this form of adhe sion results usually from an extension of ca tarrhal inflammation along the lining mem brane of the tube, which, spreading to the firnbriated extremity, gives rise to peritoneal inflammation in the vicinity of the orifice, so that the free terminations of the tube are bound down to the adjacent parts, seems to offer the truest explanation of the nature and origin of this peculiar condition of the parts. Seefig. 409.