ARTIFICIAL IMPREGNATION.
impregnation demands activity of both sexes, yet copulation is only for directly ejaculating semen within the female organs, and to facili tate contact between the ovule and the spermatozoa. Copulation is not indispensable, for there are a number of well-authenticated cases where women have been impregnated without insertion of the penis, and where semen upon the vulva has not only penetrated the vulvo-vaginal canal, but impregnated the ovule. Hence the idea of artificial impregnation. Spallauzani successfully tried it upon a bitch in 1780. Hunter, in 1799, for the first time practised it successfully in a woman. He first advised it in a case of hypospadias, and, the husband agreeing, the wife became pregnant. The practice was in oblivion for several years, but, in 1837, Dr. Girault of Paris renewed it, and many have since tried it:—among these are Marion Sims, Gigon d'Angouleme, Courty and Pajot.
In 14 cases, it has been followed by success (Gigon). But two of these 14 do not possess sufficient guarantee. Thus there remain 12 cases which are well authenticated:— Of the 12, 10 gave perfect results, living children being born. In the other 2 cases non-persistence can be adduced as a cause of failure.
To the above Gigon adds: smallness of the penis; excessive or abnor mal size of the penis; impossibility of entering in erection, or at least in such a state of erection as allows of copulation; extreme obesity; enor mous herniae; tumors about the groin; retroversion of the uterus; uterine flexions; certain abnormal forms of tho os uteri, and of the vaginal canal, and vaginismus. To artificially impregnate, Gigon makes 2 classes: 1st. Indirect.—Semen injected into the vagina, not into the uterus.
2d. Direct.—Semen injected into the uterus itself. The second is the better proceeding by far. Girault, who was the first to do this, used a simple metallic tube as large as a male sound, having at its tipper end a lit tle reservoir into which he poured the semen, kept until his arrival in a glass surrounded by tepid water. Before using the tube it should be warmed. The semen flows from this reservoir back to another, which is guarded by a faucet. The tube is introduced into the uterus, the faucet is tuned on and the operator gently blows the semen into the uterine cavity. Although primitive, this instrument was very successful in its
inventor's hands. Dr. Dehaut invented two instruments in 1865 but never used them:-1, an injector for throwing semen into the uterus; and, 2, a receiver for preserving semen at the proper temperature until injected.
Gigon, slightly modifying Marion Sims' apparatus, advises:—lst.—A thick glass syringe, graduated to millimeters, whose diameter is .39 of an inch. A tube of vulcanized rubber, with screws on one end. The cali bre of this is very small, and its capacity is known to the operator. About 1.5 inches from the point of the tube is an enlargement, preventing too deep a thrust into the womb. Ile proposes to collect the semen in the vagina when this is possible. Courty covers the penis with a condom, in which the semen remains after ejaculation, a little opening allowing the glass syringe (previously warmed to 98.2° to 107° F.) to gather the required amount.
This syringe has a metallic or elastic uterine sound, by means of which the uterine cavity is entered. The piston drives the semen into the womb.
Pajot always collects the semen from the vagina when possible. Ile used to employ a complex instrument; now he uses this: A hollow metallic tube, like that used for inducing premature labor, is covered with a rubber tube which projects beyond it by about .78 of an inch.
To one end of this rubber tube is fitted a glass tube about .8 of an inch long, pierced with a little groove, rough at one end. The other end is firmly set in the rubber tube, which ends in a flask-shape, which makes the instrument both a force and a suction pump. The operator draws directly from the vaginal cul-de-sac the semen there ejaculated. The speculum allows us to observe the exact spot of the disposition of the semen: the end of the tube, with the little glass canula, is put into the fluid, and by pressing on the rubber ball the semen is sucked into it; the canula is then introduced into the uterus, and by successive jets the semen is thrown into the uterine cavity. This is very simple, and has been success ful, once at least, in Pajot's hands.