There are many similar specimens in the museum of the Royal College of Surgeons, and I have seen some in that of Professor Meckel at Halle, and of the late venerable Professor Sœmmering, both of whom honoured me with their friendship. In the first of these three establishments there is a preparation which in many respects resembles Ovum 14. It is marked 3447 and was presented by Mr. Lawrence. Viewed externally, the Ovum in the latter case looks almost sarcomatous. It has a triangular outline with two short prolongations at each of the two upper angles corresponding with the situation of the uterine orifices of the fallopian tubes. The inner or transparent involucra of the Ovum (which is bigeminum) are covered by the cotyledonous prolongations weaved into a general placenta with its membrana propria, and a coriaceous envelope over all. The internal cavity is laid open so as to exhibit an embryo in each half of the Ovum, the one being double the size of the other. The smaller embryo is about as large as a good-sized house-fly. The cord of the largest embryo is nearly an inch and a half long, sacculent, and expanding towards the abdomen so as to form the only covering of that cavity. The cord of the smaller embryo is half an inch in length and filiform.
I have before me two other specimens of the semi-coriaceous Ovum obtained in cases of abortion which occurred in the course of my practice last year: the one in June, the other in December. In the first case the lady had had several live children, and had also miscarried often before. In the second case the lady was primiparous. Both suffered dreadfully—and it is to be remarked, that the pains experienced by the patient during the process of this species of miscarriage is always excessive, and the escape of the Ovum generally followed by violent hemorrhage. Many years ago I succeeded in saving the life of a patient of high rank, then in the country, who was sinking under an almost total loss of blood, consequent on a miscarriage of this kind, in which a large portion of the semi-coriaceous envelopes had remained behind adhering partly to the inner orifice of the womb, thereby producing and keeping up the hemorrhage. In all these cases, the Ovum could not have been in existence more than three months, reckoning from the cessation of the menses. They were all nearly of the same volume, but the size of the fœtus varied in proportion to the greater or less thickness of the envelopes.
On examining that part of the anatomical collection of the Royal College of Physicians, in London, which relates to these subjects, I found a very interesting specimen of the globular and wholly opaque Ovum, marked 7. G. No. 19. All the involucra, without any distinction, adhere together most compactly, so as to form a species of egg-shell of an equal thickness throughout; that thickness being no less than one third of an inch. The Ovum resembles in size a large duck’s egg, though more spherical than the latter.
The inscription on the label is, “A Miscarriage at Six Weeks”, but the embryo appears of no more than four weeks’ growth.
Plate 4
Joseph Perry del et Lithog. Printed by C. Hullmandel.
Dr. Granville on Abortion
and the Diseases of Menstruation
PLATE IV.
SPECIMENS OF MISCARRIAGE DURING THE THIRD AND BEFORE THE COMPLETION OF THE FOURTH MONTH.
Fig. 16. Ovum pseudo-membranosum.
(Three months and a half after the cessation of the menses.)
There are not fewer than seven membranes, or involucra of some sort or another, in this example of aborted Ovum. Its age is unknown to me, as well as its medical history. I can only judge from appearances, as the preparation speaks for itself. In one point of view, more especially, is the present diseased Ovum particularly interesting to me; for it exhibits the most distinct proof that what I call the cortex of the Ovum, and which others have, without direct evidence, considered as a membrane of the uterus, is, in good truth, a natural covering of the Ovum. It is this very natural covering of the Ovum which is liable, from disease, to become fleshy, opaque, vascular, and lastly coriaceous, thereby cutting short the supply, or accretion of substance to the fœtus, and thus destroying its life and producing abortion. Were it not so, we should not observe, as in the design before us, another membrane external to the one I allude to, as seen at the bottom and on the right of the figure, which is the true caducous or uterine membrane of authors. Its structure is far different from the former; it is of a loose texture,—I was about to say, almost gelatinous, or like a reticulated gauze.