Graphic illustrations of abortion and the diseases of menstruation / Consisting of Twelve Plates from Drawings Engraved on Stone, and Coloured by Mr. J. Perry, and Two Copper-plates from the Philosophical Transactions, Coloured by the Same Artist. the Whole Representing Forty-five Specimens of Aborted Ova and Adventitious Productions of the Uterus, With Preliminary Observations, Explanations of the Figures and Remarks, Anatomical and Physiological.

by A. B. Granville

On opening the body of the patient, who had before borne three children, and had also miscarried twice, and died when she supposed herself two months gone with child, the cavity of the abdomen was found filled with blood.

This case is related by Hendrick in the “archives”, by Horn, Sept. and Oct. 1817; transmitted and vouched to Dr. Breschet of Paris by Professor Carus of Dresden, who sent the drawing, from a lithographic copy of which the present plate is taken.

Fig. 2. Ovum embryoferum in receptaculo interstitiale.

Uterus enlarged; more so on the right than on the left side. A three-lobulated tumour or swelling of the substance of the womb immediately above the insertion of the right Fallopian tube, and on the external surface. Ulceration of the coats of this swelling, which had taken place during life, exhibits to view an excavation or cyst in the interstitial substance of the uterus, containing an embryo which appeared to have acquired a growth of six weeks.

The cavity of the womb had no communication whatever with the fœtiferous cyst. It was found lined with a woolly pseudo-like membrane.

The internal or uterine orifice of the right Fallopian tube was absolutely impervious: that of the left open; but the fimbriated end of the latter was closed, and some serum was found within the tube.

The patient had had several children before: the last time she was pregnant she miscarried at four months. On the present occasion she was not conscious of being with child, as she continued to be regular every month; whereas during every preceding pregnancy her menstruation had ceased. She felt better than usual on the day of her death, soon after which, on opening the abdomen, the above appearances offered themselves to view. There was a large quantity of blood in the cavity of that region.

This case is quoted by Dr. Breschet from a memoir in the Transactions of the Medico-Chirurgical Society of Vienna for 1801, drawn up by Professor Schmidt, and farther vouched by Professor Carus.

REMARKS.

Cases of aberration in the first development and ultimate station of the human embryo like these, were not known to science (according to Dr. Breschet’s statement) before the two preceding instances were laid before the profession. I selected them, therefore, on account of their priority, from among the six cases collected by that indefatigable and highly gifted anatomist, whom I am proud to call a very old friend, in his memoirs on “A New Species of Extra-uterine Pregnancy,” published in the first volume of a very valuable work, edited by himself, Dupuytren, and others, in 1826, entitled, “Repertoire General d’Anatomie et de Physiologie.” The facts are singular, yet authentic in all their particulars. It is, therefore, impossible to deny the existence of another distinct species of pregnancy, extra muros uteri, in which the fœtus is lodged among the interstitial elements of that viscus, and has no communication whatever either with the cavity of it on the one side, or the cavity of the abdomen on the other; unless ulceration or laceration take place.