The Uterus and its Adnexa
F U, Fundus or Base of the Uterus. F T, P T, Fallopian Tubes. On the left of the reader the Fimbriated Extremity of the tube is lifted up to show it. O, O, Ovaries. B L, B L, Broad Ligament. R, Rectum. B, Bladder.
For convenience in description, each tube is divided into four parts: (1) the Uterine Portion, which is that part included in the wall of the uterus itself; it extends from the outer end of the horn into the upper angle of the uterine cavity, and its lumen is so small it will admit only a very fine probe; (2) the Isthmus, or the narrow part of the tube which lies nearest the uterus; it gradually opens into the wider part called (3) the Ampulla; (4) the Infundibulum, or the funnel-shaped end of the Ampulla. This part is fimbriated, as has been said, and one of the fimbriae—the Fimbria Ovarica—which is longer than the others, forms a shallow gutter which extends to the ovary.
The uterus, tubes, and ovaries lie in a septum which reaches across the pelvis from hip to hip. This septum is called the Broad Ligament. If a man's soft felt hat, of the kind called a "Fedora" hat, is held crown downward with one hand at the front and the other at the back of the rim, it will represent the pelvic cavity, and the fold along the crown of the hat coming up into this cavity is very like the Broad Ligament. As the crown is held downward, the uterus would be in the middle, its fundus upward, and, of course, altogether outside the hat, but in the crown fold. The tubes and ovaries would also be outside the hat and in the crown fold, and the fimbriated extremities would open by holes into the hat's interior.
The ovum breaks through the surface of the ovary, passes, probably on a capillary layer of fluid, into the fimbriated extremity of the tube, and then is moved along slowly through the tube into the uterus. Ovulation and menstruation occur about the same time, but often one antedates the other a few days. In exceptional cases they may occur independently.
If the ovum produced is not fecundated, it gradually shrivels up, and passes off through the uterus and the vagina. Fecundation of the ovum rarely occurs in the uterus, but ordinarily in the Fallopian tube, according to the general opinion of physiologists. After fecundation the ovum is pushed on into the uterus in from five to seven days, where it fastens to the wall and develops. Hyrtl (Kollmann's Lehrbuch der Entwickelungsgeschichte des Menschen, Jena, 1898) speaks of a case in which the ovum appeared to reach the uterus in three days. If the fecundated ovum is blocked or held in the Fallopian tube, the embryo grows where the ovum stops, and we have a case of Ectopic Gestation.
The average time of normal human gestation is ten lunar months or forty weeks. At the moment the pronucleus of the spermatozoon fuses with the pronucleus of the ovum in the Fallopian tube and makes the segmentation nucleus, in my opinion, the soul of the child enters, and personality exists as absolutely as it does in a child after birth. It is as much a murder, as such, to unjustly destroy this microscopic fecundated ovum as it is to kill the child after birth. This is the opinion of every embryologist I have consulted on the [{4}] subject, with the exception of one who said he did not know when the soul enters.
Technically the product of conception is called the Ovum for the first two weeks of pregnancy; during the third and fourth weeks it is called the Embryo, and after the fifth week the Foetus. During the fourth week the embryo begins to draw nourishment from the maternal blood through its umbilical vessels, but before that time it obtains nourishment by osmosis.
The foetus at the end of the eighth week is about one inch in length; at the end of the fourth lunar month it is from four to six inches long, and its sex may be distinguished. At the end of twenty-four weeks, if the normal foetus is born it will attempt to breathe and to move its limbs, but it dies in a short time. At the end of twenty-eight weeks of gestation if it is born it moves its limbs freely and cries weakly. It is nearly fifteen inches in length and weighs about three pounds. Such an infant might be deemed viable, but its chances for life are extremely precarious, even in most expert hands and with the help of an incubator. At the end of thirty-two weeks of gestation a foetus if born may be raised with skilful care, but the chances are not promising. It is viable. At the end of forty weeks the child is at term.