Femina, A Work for Every Woman

by John A. Miller

CHAPTER XXI.

DISEASES OF THE FALLOPIAN TUBES.

The Fallopian tubes are the ovi ducts, along which the spermatozoids pass from the womb to fertilize the ovum, and along which the fertilized or non-fertilized ovum, as the case may be, is carried to the cavity of the uterus.

They are two small canals, between three and a half and four inches in length, and constitute the only means of communication between the womb and ovaries; their caliber is exceedingly small and lined with a delicate mucous membrane.

The diseases which affect the Fallopian tubes are inflammation, stricture, distention and displacements.

The inflammation is distinguished as salpingitis, from salpinx, Fallopian tube, and itis, in composition, inflammation; this consists of a catarrhal inflammation of the lining membrane of the tubes, which rarely if ever originates in the tubes themselves, but is secondary to an inflammatory process in the neighboring organs.

Chronic endometritis or catarrh of the womb is undoubtedly the most fruitful cause of salpingitis, although this is not absolutely the rule, for there are some women who have had uterine catarrh for years without its affecting the tubes in the least. But there is a type of uterine catarrh that has a special tendency to spread from the womb to the lining membrane of the tubes, and this is the infectious endometritis. An infectious inflammation of the womb may be due to many different sources of infection; the retained products of conception after an abortion may become putrescent and furnish one source; carrying putrefactive germs into the uterine cavity from the vaginal canal by means of probes or instruments, that are in themselves defiled by not having been thoroughly cleansed and purified since their last employment, is another source of infection; the latter is perhaps the commoner cause of blood poisoning in criminal abortions by the abortionists. Gonorrhœal infection seems to have a greater tendency than any other to spread itself from the uterus to the tubes; this has been the subject of special inquiry, and has been thoroughly confirmed, and this may arise many months after the infected male has imagined himself entirely cured.

The diseases of the tubes that I have enumerated are in the relation of cause and effect; a catarrhal inflammation is quite likely to induce a stricture or an occlusion, and this causes a distention from retention of the secretions, whether the secretions are a natural or an inflammatory product. If the inflammation has an infectious origin, then the retained secretion becomes purulent, or it may be a muco-pus secretion from the commencement. The dilated tube may also contain blood or serum; the latter constitutes tubal dropsy; or it may contain a fertilized ovum; this gives rise to tubal pregnancy.

Tubal dropsy may be a distention of the tubes when both ends are sealed by inflammatory adhesions; these distentions vary in size from the thickness of a finger to a large ovarian tumor, from which it is not an easy matter to distinguish it.