Chapter I: Part 1

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, M.D., F.R.S., F.L.S., F.G.S., F.R.A.S.,
ETC. ETC. ETC.
FOR FIFTEEN YEARS PHYSICIAN-ACCOUCHEUR TO THE WESTMINSTER GENERAL
DISPENSARY, AND DURING TEN YEARS PHYSICIAN TO THE BENEVOLENT LYING-IN
INSTITUTION.

LONDON:
PRINTED FOR JOHN CHURCHILL,
Medical Bookseller and Publisher,
16, PRINCES STREET, SOHO.

MDCCCXXXIV.

G. WOODFALL, ANGEL COURT, SKINNER STREET, LONDON.

HENRICO HALFORD,

BARONETO,

EX GUELPHORUM EQUITUM PRIMÂ COHORTE; BRITANNIARUM REGIS ARCHIATRO;
COLLEGII REGALIS MEDICINÆ LONDINENSIS PRÆSIDI;

MEDICO DOCTO, PERITO, FELICI,

IN OMNI DOCTRINÆ GENERE ILLUSTRI,

OBSERVANTIÆ ET AMICITIÆ ERGO

GRAPHICA HÆC LINEAMENTA

D.D.D.

AUCTOR.

------------------------------------------------------------------------

CONTENTS.

DEDICATION.

Advertisement, XI.

PROLEGOMENA, p. i.–xxi.

Perfect (Normal) Animal Reproduction, prop. 1–3.

Imperfect (Anormal) Animal Reproduction (Abortion) prop. 4–7.

Study of Abortion, prop. 8–12.

CONCEPTION, prop. 13.

Ovulum (Description of before Fecundation), prop. 14–17.

FECUNDATION, prop. 18.

Ovulum (Description of after Fecundation), prop. 19–22.

CORTICAL MEMBRANE of the Ovulum, prop. 23–26.

Deciduous Membrane of the Uterus, prop. 27–31.

Corpora Lutea, prop. 34–37.

Transit, Volume, and First Development of the Ovulum, prop.
38–42.

THE CHORION, prop. 43–44.

Structure, Function and Vascularity of the Chorion, prop. 45–51.

Fluid of the Chorion, prop. 55.

THE AMNION, prop. 54.

Structure, Function and Vascularity of the Amnion, prop. 52–54.

Fluid of the Amnion, prop. 53.

Progressive Increase of the Ovulum, prop. 56.

Independent Life of the Ovulum, prop. 57–59.

Earliest or Mechanical Connection of the Ovulum with the Uterus,
prop. 60.

Metamorphoses of the newly engendered Being, prop. 61.

Growth and Progress of the Embryo and Fœtus, prop. 62–66.

Priority of the Vascular over the Nervous System in the Fœtus,
prop. 67.

Formation of the Blood in the Fœtus, prop. 68.

Formation of the Nerves in the Fœtus, prop. 69.

Apparatus for Digestion, prop. 70.

VESICULA UMBILICALIS, prop. 71.

THE ALLANTOID, prop. 72.

THE UMBILICAL CORD, prop. 73–75.

Omphalo-mesenteric Vessels, prop. 76.

More advanced, or Vascular Connection of the Ovum with the
Uterus, prop. 77,

FIRST FORMATION OF THE PLACENTA, prop. 77.

Cotyledons of the Placenta, prop. 78–80,

Deciduous Vessels of the Placenta, prop. 81–83,

Membrana Propria of the Placenta, prop. 84.

Proofs of the Existence of Deciduous Vessels in the Placenta,
prop. 85.

Deciduous Vessels, form the connecting Vascular Link between the
Uterus and Placenta, prop. 86.

Proofs of it from Anormal Anatomy, prop. 87.

CIRCULATION, Utero-fœtal, prop. 88 and 90.

Recent Fallacies respecting the Structure of the Placenta, prop.
89.

FUNCTIONS OF THE PLACENTA, prop. 91.

Physiological Proofs of the Deciduous and Fœtal Structure of the
Placenta, prop. 92.

NUTRITION of the Fœtus through the Placenta, prop. 93.

Lymphatics and Lymphatic Absorption in the Placenta, prop. 94.

Pretended Nutrition by the Amnionic Fluid, prop. 95–96.

RESPIRATION of the Fœtus in Utero, prop. 97.

Nature of the Changes in the Fœtal Blood, prop. 98.

Bile secreted by the Placenta, prop. 99.

Distinction between Life and Nutrition in the Fœtus, prop.
100–102.

EXPLANATIONS OF PLATES, AND REMARKS.

PLATE I. page 1–6.

SPECIMENS OF VERY EARLY MISCARRIAGES.

Remarks on Fig. 1 and 2. page 2.
Remarks on Fig. 5, 6, 7, 8, 9. p. 5.

PLATE II. p. 7–8.

MISCARRIAGE BETWEEN TWO AND THREE MONTHS.

Remarks on Fig. 10, 11, 12. p. 8.

PLATE III. p. 9–12.

MISCARRIAGE BETWEEN TWO AND THREE MONTHS.

Remarks on Fig. 13, 14, 15. p. 11.

PLATE IV. p. 13–16.

MISCARRIAGE DURING THE THIRD AND BEFORE THE COMPLETION OF THE FOURTH
MONTH.

Remarks on Fig. 16. p. 14.
Remarks on Fig. 17. p. 15.

PLATE V. p. 17, 18.

MISCARRIAGE BETWEEN THE THIRD AND FOURTH MONTH.

Remarks on Fig. 18. p. 17.
Remarks on Fig. 19. p. 18.

PLATE VI. p. 19–24.

MISCARRIAGE BETWEEN FOUR AND FIVE MONTHS.

Remarks on Fig. 20. p. 20.
Remarks on Fig. 21. p. 22.
Remarks on Fig. 22. p. 23.

PLATE VII. p. 25–26.

MISCARRIAGE AT FIVE MONTHS.

Remarks on Fig 1. p. 26.

PLATE VIII. p. 27.

FIRST SPECIMEN OF ABERRANT GESTATION.

Remarks on Fig. 1. p. 28.

PLATE IX. p. 29.

SECOND SPECIMEN OF ABERRANT GESTATION.

Remarks on Fig. 1. p. 30.

PLATE X. p. 33–36.

THIRD SPECIMEN OF ABERRANT GESTATION.

Remarks on Fig. 1. p. 33.
Remarks on Fig. 2. p. 35.

Classification of Erratic (Extra-uterine) Gestation. p. 35.

PLATE X. (A.) p. 37–38.

FOURTH SPECIMEN OF ABERRANT GESTATION.

References to Do. p. 37.

PLATE X. (B.) p. 39–40.

CONTINUATION OF ABERRANT GESTATION.

Remarks on Do. p. 39.

PLATE XI. p. 41–44.

DYSMENORRHOIC ORGANIZATIONS.

PLATE XII. p. 45–51.

POLYMENORRHOIC STRATIFICATIONS.

Remarks on Figs. 1, 2, 3, 4, 5. p. 48.

Classification of the Adventitious Productions of the Uterus. p. 48.
Classification of the Diseases incidental to Menstruation. p. 48–49.

Synopsis of a Work on Abortion. p. 51–52.

LIST OF THE FORTY-FIVE COLOURED FIGURES OF HUMAN OVA, AND ADVENTITIOUS
PRODUCTIONS OF THE UTERUS REPRESENTED IN THE PLATES.

1. Ovulum bigeminum lanuginosum.

2. Ovulum semi-lanuginosum.

3. Ovulum lanuginosum.

4. Ovulum semi-lanuginosum.

5 and 6. Ovula of the same species.

7. Ovum denudatum, or diaphanous Ovum.

8 and 9. Ova of the same species.

10. Ovum piriforme externè opacum.

11. The same laid open.

12. Ovum opacum plethoricum.

13 and 14. Ova semi-coriacea.

15. Ovum omnino opacum rotundum.

16. Ovum pseudo-membranosum.

17. Ovum uviforme.

18. Ovum coriaceum, cum hydrope funis et placentâ hydaticâ.

19. Ovum cum placentâ, nec vasculare nec plene cotyledonica, sed
filiforme. Amnion morbosum.

20. Ovum tuberculosum.

21. Ovum pane solidum. Placenta sarcomatosa cum tuberculis. Involucra
fœtüs solidificata.

22. Ovum cum involucris internis ab amnio-chorionitide condensatis.

23. Ovum fœtiferum optimè conditum, subitò, ab amnio-chorionitide
interfectum.

24. Ovum fœcundum in receptaculo Ovarico.

25 and 26. Ovum fœcundum in receptaculo Tubico.

27 and 28. Ovum fœcundum in receptaculo Interstitiale.

29. Ovum fœcundum in receptaculo Ovarico.

30. The sac of the preceding Ovum laid open.

31. Membrana pseudo-textilis intro-uterina bi-tubulata.

32. Membrana pseudo-textilis intro-uterina sine tubulis.

33. Coagulum intro-uterinum hæmatosum pseudo-membranaceum incavum.

34. Coagulum intro-uterinum hæmatosum laminare cavum.

35. Coagulum intro-uterinum spongiosum cavum, interne velatum.

36 and 37. Coagulum intro-uterinum, interne solidum, externe
membranaceum.

38. Mola avellana tunicata.

39. The same laid open.

40. Mola avellana nuda.

41. The same laid open.

42. Mola conchula.

43. The same laid open.

44. Mola Mytilus.

45. The same laid open.

N. B. In the last Plate, the figures 2 and 3 should be reversed, in order to correspond with the text or printed explanations.

ADVERTISEMENT.

I submit to my professional friends and acquaintances, as well as to all those medical brethren who take an interest in the progressive advancement of the sciences they cultivate, a series of beautifully executed Drawings of anatomical preparations, intended to explain and illustrate the important subjects of “Abortion”, and “The Diseases incidental to Menstruation”; subjects in which all classes of the medical profession, whether specifically devoted or not to obstetrical practice, are equally interested. The drawings speak for themselves. The Artist, under my immediate and constant superintendence, and with the anatomical preparations in every case before him, explained and demonstrated to him, has, in the course of six years, been able to produce twelve plates, containing upwards of forty anatomical figures, lithographed and coloured by himself, which reflect no small honour on the arts of this country, and are highly creditable to his abilities. These plates, I will venture to say, leave nothing to be desired in such a mode of representing anatomical subjects, (a mode which appears from the present endeavours to be the best calculated of any for that purpose,) whilst they remove every cause of regret, hitherto entertained, that the most successful efforts of anatomical lithographic representation, of which foreign countries can boast, had never yet been equalled in England. It may now be asserted that those efforts have been triumphantly rivalled by Mr. Joseph Perry on the present occasion; and, in some of the plates, unquestionably surpassed.

Having said thus much in favour of the Artist, I hope I shall be excused if I add, for myself, that I have selected such specimens only as I considered likely to illustrate some of the most interesting points of the physiology of human generation, and which might assist in unravelling the various practical difficulties which beset that mysterious question;—that I have chosen those which, I believe, (with the exception of one or two preparations,) have never been published before either in this or any other country, and many of which are to be found only in some private anatomical collection;—that I have explained them in such a way as to render their meaning and usefulness evident to all my brethren;—and that, under such circumstances, I venture to believe that the plates so explained will prove of no inconsiderable service to every medical practitioner as a work of reference, where either a private or a public museum is not at hand to solve cases of doubt.

I am aware that I might have extended this series of representations to more than double the present number of analogous preparations; but I purposely limited it to what it is, from a consciousness that any unnecessary increase in the number of plates, which the peculiarity of the subject did not absolutely require, would only tend to increase the bulk, and with it the expense of the “Graphic Illustrations”, without any adequate or corresponding advantage.

It may, after all, be asked: were these delineations wanted? Were there not already in existence works of a similar, or at least analogous character, executed in an equally masterly style, to which the medical reader and the physiologist could refer for information and in cases of doubt? I reply, yes, to the first—and negatively, to the second question.

And first, of the second question. Not to speak of the many authors on matters of this description, who preceded Dr. Hunter and Professor Soemmering, in giving representations of the human embryo in many of its metamorphoses, such as Ruysch, Noortwyk, Albinus, Krapft, Wrisberg, Camper, Blumenbach, Denman, and others, I am ready to admit that both Hunter and Soemmering had given to the world delineations, such as are here referred to, which ought to satisfy the medical profession. The one in his splendid work on the “Gravid Uterus”, gigantic folio edition—the other in his no less valuable folio plates of the human embryo. But, unfortunately, neither of those works can be considered as accessible to the generality of professional readers, on account of their high price and rarity; and even if either were accessible, the subjects therein treated are viewed differently from those collected in the present work. Those works, moreover, present no coloured specimen of delineations of parts, most of which, if not all, from that simple circumstance, lose their principal value;—and as productions of art they are not equal to what Mr. Perry has enabled me to offer to the public. Soemmering himself, in his “_Icones Embryonum Humanorum_”, admits, that although those who had gone before him in the same channel of inquiry, had produced valuable works and splendid plates, particularly Dr. Hunter and Dr. Denman; there was yet room for a more complete, and, above all, for a more minute representation of the metamorphoses of the human embryo. “_Elegans profecto et utilis admodum speculatio!_” exclaims the veteran physiologist; and forthwith he proceeds to compare what he had been able to give to the public on the subject of embryology with that which his predecessors had done. This leads him to the conclusion that, from having paid greater attention to minuteness, from being more strictly accurate, from the advantage of having a better collection of specimens than fall to the lot of most anatomists, and from the circumstance of both his delineator and engraver being much superior to those of former times—he had been able to complete a work of art on the progressive development of the human fœtus which left those of his predecessors far behind.

With one or two exceptions, the representations in Soemmering’s work are simply those of the fœtus in its progressive advancement from the third week after fecundation, to the fifth or sixth month of gestation. Those representations have no reference to the whole ovum at those several periods of fecundation: and they are not coloured. Still they are, as he has stated, superior as a work of art to any that had appeared before. Soemmering tells us that he selected for his plates the best specimens of the human embryo, the best draughtsman, and the most skilful engraver; and that when he compared those plates with those of Trioenius, Albinus, Wrisberg, Hunter, and Denman, in order that he might better understand, explain, and perhaps correct his own: “_magnopere delectabatur_”, to find, on such a comparison, that the superiority of his plates was not inconsiderable. Well, then, let the reader who has the means of doing so, turn to the two folio plates of Soemmering, and then direct his attention to the fourteen plates contained in the present volume, and I will abide by their decision whether or no, in all such delineations as relate to either parallel or identical subjects in the two publications, the palm of superiority (in every circumstance of design, precision, and execution,) which Soemmering claimed for _his_ publication, ought not to be yielded by him to _another_ sent forth under the advantage of recent improvements in drawing, and a newly invented art admirably adapted for such imitations of nature. Independently of which advantages there is to be added the charm of colour—a circumstance which so greatly embellishes, without disfiguring, truth.

With such impressions, I can feel no hesitation in giving publicity to my collection; and if in selecting, denominating, and appropriating to particular views of my own the several specimens I now publish, there should be found neither taste nor judgment, novelty nor utility, the blame must rest on me—but the merit of superiority will still remain to it as a work of art, which, in the department of morbid embryology, has at present no equal either in England or on the Continent.

Now to the first question—whether these delineations were wanted? I support the affirmative by appealing to all those of the profession who have had occasion to be consulted in cases of abortion and the expulsion of those singular productions of the uterine cavity, which seem connected with menstruation or faulty conception. Let them say whether a work, in which the principal of the infinitely varied aborted human ova, and of the uterine productions alluded to, are faithfully represented, be not likely to be useful; whether, in fact, it be not wanted—or whether it exist already anywhere. If the want of such a work be made manifest, its importance must be self-evident. But that importance is not a little enhanced when we find Denman—a plain unsophisticated practitioner—with quite enough of science to constitute him an authority in physiological questions concerning human generation,—recommending the inquiry, in his own work on an analogous subject, entitled “Engravings representing the Generation of some Animals”, in which he has given three drawings of aborted ova. “It must be allowed”, observes the Doctor, “that the generality of these things (the aborted ova) are preserved for their beauty, or as matter of curiosity, rather than of use. I suspect, nevertheless, that there are some appearances besides the _vesicula umbilicalis_ not yet perfectly understood, and therefore recommend the whole subject as worthy of being reviewed”: and, in a subsequent part, he says, that “in every collection there must be some example, which may enable us to distinguish the different parts of which an ovum is composed, the proportion which they bear to each other at different periods of pregnancy, and sometimes the process of utero gestation which failed”. What greater encouragement, therefore, needed I than this opinion and advice of one of the best obstetricians England can boast of, to select, prepare, and point out the importance of this species of anatomical and physiological delineations?

I shall conclude, by remarking, that the plates are intended to illustrate a work “On Abortion and the Diseases incidental to Menstruation”, which I have been preparing for several years, and a prospectus of the contents of which will be found at the end of the present volume. That work will appear, DEO favente, in the course of the present year; but for the convenience of such persons as may not feel inclined to purchase it, the collection of plates has been purposely so arranged, as to be published, with a corresponding text, in a separate form, and independently of the forthcoming volume.

_Grafton-street, Berkeley-square, 30th March, 1833._

PROLEGOMENA

OF

THE DEVELOPMENT AND METAMORPHOSES

OF

THE HUMAN OVUM.

PROLEGOMENA.

1. The ultimate purpose of nature, in associating the two sexes in the human species, is to bring to maturity and produce, in a fit state to live and procreate, a constant succession of individuals, that shall perpetuate the species to the end of time.

2. This object is invariably accomplished by one uniform series of laws and phenomena, which have been studiously inquired into, accounted for, and, in most instances, explained in a satisfactory manner, amounting almost to demonstration.

3. The study of the function of reproduction, in all the other classes of animals, affords no other nor any dissimilar evidence. On the contrary, both by comparison and analogy, the study in question serves to confirm us in the notion, that Man differs in nought, in this respect, from the animated beings placed below him in the scale of creation. One same primary intention is manifest in their sexual distinctions; the means to ensure the ultimate purpose—their perpetuation—are the same; the same laws and the same phenomena mark the appearance, the development, and the final production of successive generations of individuals.

4. Any deviation from those laws—any violent change in those phenomena—and, still more so, any impediment to the accomplishment of the _ultimate purpose_ of Nature, is a defeat of her intention.

5. Such a deviation, change, or impediment may occur at any time previously to the period established for the appearance of a new and perfect being. If it occur at such a time as shall be incompatible with the maturation, and consequently with the life of the new creature, or even with its maturation alone, (although tokens of life be observed at the time in question,) a MISCARRIAGE is said, in common parlance, to have taken place; for Nature has _miscarried_ in her undertaking: she has been foiled in her expectations.

6. In the reproduction of the human species, such an event might justly be considered to have occurred, if, at any time before the completion of the natural period of gestation, the fœtus be expelled, whether dead or alive. But as in many instances, notwithstanding its premature expulsion, the fœtus has grown and has continued to live its extra-uterine life, in spite of the want of maturity, (a case known to have occurred even so early as between the sixth and the seventh month,) the expression, before mentioned, (5) is not applied to any untimely expulsion of the fœtus that may take place later than that period—at which, and after which, and till the completion of the ninth month of gestation, such an expulsion would be called a _premature_ labour. The distinction, however, is more specious than useful: it is an offering to social etiquette, rather than to science.

7. The premature expulsion of the produce of conception before the seventh month, has also received the name of ABORTION. This denomination has been generally adopted, and is used by the writers of every civilized nation, ancient or modern, according to their respective languages. It is that which has been employed in the following explanations of figures taken from nature, which are intended to exhibit several examples of abortion in the human species.

8. The study of abortion, in this point of view, (7) is an infinite source of interest, whether considered in reference to science and the important question of generation, or simply in reference to medical practice. On the continent of Europe, and even in the States of America, but more particularly in Germany, the subject, under its two-fold aspect, has engaged the serious attention of some of the most learned philosophers and most skilful practitioners. I know of no other professed writer on the same subject, besides Burns, in this country. His work on abortion is brief, and more valuable for the practical suggestions it contains, than for any luminous or accurate view of the various scientific points connected with that subject. But like every thing which proceeds from the hands of that able practitioner, the performance is respectable.

9. It is impossible, thoroughly and accurately, to comprehend the mode in which abortion takes place, without being previously acquainted with the origin, formation, progress, and metamorphoses of the fœtus, and its connection with the mother. On all these points, we have, until lately, been in the habit of professing the same articles of belief as our predecessors: we have repeated what we heard them say, or what we read in their writings; and many, both here and elsewhere, repeat still the antiquated theories respecting conception and the structure of the human ovum, which they have learned on the obstetrical benches.

10. The great advancement—the great and forward strides which physiology has made in France, as well as in Germany, have contributed to explode those antiquated theories. Acute and indefatigable anatomists have been busy watching Nature in all her movements, from the first moment of her calling the rudiments of a human embryo into existence, until her magnificent work has been completed by the production of a new, life-gifted, individual of the species. They have called to their aid the much improved art of microscopical observation, and have thereby succeeded in almost tracing the very earliest instant of embryonic existence. The register of their observations constitutes the biography of the human fœtus.

11. It is with the view of contributing to the common stock of new and interesting information on this all-important question, that I bring forth the result of my inquiries into the morbid state of the human Ovum, and its structure under circumstances of premature expulsion. If such inquiries have led me to adopt the improved notions of the more modern physiologists and anatomists in these matters (which I have professedly studied, and have had the most ample opportunities of studying for many years); they have, likewise, enabled me to detect some of the oversights of those observers, and to add a little to what has already been brought forward; while, at the same time, they have induced me to join that class of writers who dismiss, as inconsistent with facts, the theories and assumptions of olden times, whose strongest authority has been their mere repetition.

12. The ideas which are now entertained respecting fecundation, after the successful congress of the two sexes, in the human species—respecting its seat—respecting the first origin, station, and rudimental creation of the embryo—respecting the journey of the latter into the womb, its sojourn in that cavity, and the various metamorphoses it undergoes therein, up to the period fixed for its projection into the WORLD, may be comprised within a small number of propositions. I shall support those propositions by references to facts, or the quotations of competent authorities, and the allegation of anatomical discoveries. But as the object of the present work is to illustrate abortion, and not the complete life-circle of the fœtus, I shall stop the number of my propositions at the _fifth_ month of its intro-uterine existence. After that period, the various phenomena of fœtal gestation are so uniform, that they afford less matter of interest to the philosopher.

13. CONCEPTION, or that result which follows sexual congress, in virtue of which one, or more individuals, of the same species is called into being, takes place in the ovarium of women. This is doubted by Meckel and others, who look upon all cases of ovaric gestation (see Plates IX. and X, A. and B.) as mere accidents, and as only proving that if conception has not before taken place in the womb, it _may_ take place in some other part connected with it; but the point has been set at rest by the more recent experiments and microscopical observations of Professor BOER, of Kœnigsberg. I adopt his conclusions. Their correctness is corroborated by the interesting experiments of Prevost and Dumas, although these experimenters admit not that fecundation takes place in the ovarium.

14. The intended receptacle of the embryo is the OVULUM. An ovulum exists in all the vesicles of Graaf, which the ovarium of a woman, who has reached maturity, contains.

15. Viewed by means of a powerful microscope, the ovulum is found to consist of a small yellow spherical body, placed within the vesicula Graafiana, with the upper portion of which it is, internally, in contact; so that it does not float freely in the liquid of that vesicle. This contact becomes more and more intimate as the ovulum enlarges, when that part of the capsule of the vesicle which lies over it becomes, in a correspondent degree, thinner.

16. At first, the little yellow body, being rather opaque, is distinctly seen even without a magnifying glass; but as it advances, it becomes more transparent and, consequently, less distinguishable.

17. This little yellow body is a minute spherical mass, with a roughish or slightly granular surface, and is hollow. Its parietes are thick; around them is an envelope of a much thinner texture, which is distinctly seen, owing to a small space lying between it and the surface of the little yellow body, which space is filled with a fluid substance of a peculiar nature.

18. When FECUNDATION takes place, that part of the vesicle of Graaf to which adheres, internally, the ovulum, bursts, and the ovulum escapes with its external envelope, together with a small portion of the liquid peculiar to the Graafian vesicle, and thus it passes into the fallopian tube.

19. Independently of the external envelope, and within it, the microscope has detected, after fecundation, the existence of another covering, completely investing the little spherical yellow body.

20. The ovulum has been traced, after fecundation, into the cavity of the womb, where the external covering (17) becomes what Boer has called “the cortical membrane”, (_cortex ovi_ of the present work,) improperly considered as a uterine production by preceding writers, and denominated the _reflected_ caducous or deciduous membrane.

21. The more intimate covering of the yellow body of the ovulum, that which closely invests its surface, and appears only after fecundation, (19) is afterwards changed into what has been denominated the shaggy chorion: my observations and my plates shew this. Boer, however, professes not to know what becomes of it during the progressive intro-uterine development of the ovulum.

22. The hollow and spherical yellow body of the ovulum corresponds with the yelk or _vitellus_ of the ovum of oviparous animals, and from it all the other several parts of the fœtiferous ovum are derived or formed, as gestation advances, and a progressive development of the parts takes place, from within, without[1].

23. The existence of the cortical membrane is proved in many parts of the present work, but particularly by Fig. 15, Plate III., and Fig. 17, Plate IV. in both of which specimens of abortion, the said _cortex_ had persisted to a longer period than usual during gestation, and had become, consequently, thickened, opaque, fleshy indeed, and the cause of abortion. Figure 15, too, shews strongly the probability of my notion that the thin membrane investing the surface of the yellow body of the ovulum is, in good truth, what has been usually denominated the shaggy chorion.

24. Another proof, amounting to demonstration, of the existence of a cortical covering to the human ovulum, and that of the filiform envelope called the shaggy chorion within it, I find in a striking and beautiful preparation belonging to Sir Charles Clarke, marked 87. We there see a complete cast of the lining (caducous membrane) of the uterine cavity after fecundation, thrown off at a very early period, and with it the ovulum, (of the size of a Portugal grape,) exhibiting the _cortex ovi_, shelly and membranaceous, of a dense texture, yet flexible, which has burst like the pericardium of some seeds, and allows the shaggy chorion beneath it to be seen. It is a curious fact, that even Ruysch has, in his fanciful manner, represented a human ovulum of about three weeks with the cortex burst, yet still _in situ_, and the shaggy chorion beneath it, in every way resembling the specimen of Sir Charles Clarke’s in the Museum of St. George’s Hospital.

25. Even the errors of some of the very able anatomists of the present day come in beautifully to corroborate Professor Boer’s observations of the cortical membrane. Breschet and Velpeau, for instance, state, that within what they (with their predecessors) have looked upon as the decidua in the human ovum, there is a cavity containing a peculiar liquid which, in their opinion, is essential to the nutrition of the fœtus. Now what is this but the very description of the ovulum by Boer (17), proving that there is a cortical membrane in the human ovum?

26. The cortical membrane is destined to be absorbed during the first months of utero-gestation, thus exposing the next membrane to the contact of the uterine lining (decidua), with which a connection takes place in that part where the placenta is to be formed. In that part, however, the cortex ovi is never altogether obliterated, but only made thinner; and, in process of time, it is converted into a mere pellicular envelope, which not only serves to divide the filiform vessels of the chorion into groups or cotyledons in order to form the placenta, but also covers all over those cotyledons or groups of vessels. (Plate I. Expl. of Fig. 1.) I have called this the _membrana propria_[2].

27. While the process or metamorphosis of the ovulum noticed by Boer takes place in the ovarium, in consequence of fecundation, the cavity of the womb does not remain idle, but forthwith sets about weaving for itself a general lining—a sort of pseudo-textile membrane—which extends all over the cavity, descends partly into the cervix, and is _often_, (not necessarily always,) projected even into a great portion of the fallopian tubes.

28. This adventitious lining of the cavity of the womb is formed quite independently of the presence of the ovum, for it has been found in most cases of devious gestation, where the fœtus was _extra muros uteri_ (Plate VIII. IX. X. Fig. 1 and 2, and page 35), and has been found advanced in its progress of formation, while the ovulum was, as yet, on its way through the fallopian tube after fecundation. (Haller, Lobstein, Velpeau, Meckel, Pockels.)

29. To this adventitious lining described by many ancient authors, but by none better than by Harvey, the name of decidua already mentioned (24, 26) has been given by Hunter, because, viewed as a production of the uterus it is caducous and not permanent like its own natural lining; as, however, it is no more caducous than any other of the involucra of the ovum, the denomination is not strictly correct. It is, nevertheless, more generally adopted than that of epi-chorion, given to the same pseudo-membrane by Chaussier.

30. Its mode of formation and its structure have been differently explained by different authors. The explanation offered by Burns runs counter to facts and realities. That author speaks of all the minute steps of generation, with the same confidence as if all had been demonstrated. His imaginings respecting primary and secondary vessels shooting out from the inner surface of the womb to form the decidua must be gratuitous, as no other anatomist or physiologist, either before or after him, has been able to ascertain the reality of such a process.

31. It is probable that the decidua consists of two laminæ, inasmuch as we always find it with one surface perfectly smooth and the other rough. If so, they are most intimately connected. It is at least one-twentieth of an inch in thickness during the first five or six weeks of uterofœtation, when its tissue is found to be more knotty, coarse, and full of short threads, (not unlike a very ordinary mat,) than a purely membranaceous or cloth-like lining would be. It is not until a more advanced period of gestation that the decidua becomes distinctly membranaceous, in which state it lines the entire cavity of the uterus. (Plate IX. and prep. 73, 75, 76, of Sir Charles Clarke’s Collection: also Dr. Agar’s beautiful specimen of impregnated uterus, Mus. Coll. Reg. Lond. Med., and several specimens in the College of Surgeons, particularly Sir W. Blizard’s case.)[3]

32. Into this chamber, then, so lined and so prepared the fecundated ovulum, in the condition described by Professor Boer, is received after its journey from the ovarium through the fallopian tube.

33. The pre-existence of an ovulum in the Vesiculæ Graafianæ, or Ovarian Vesicles—and its metamorphosis, after fecundation (14, 15, 16, 17, 18,) have been amply confirmed by Plagge of Bentheim, who published an account of his experiments and observations, illustrated by figures, in Meckel’s Journal of Physiology. (See also Prevost and Dumas, 3rd memoir.)

34. As soon as the Ovulum has departed from its vesicular nest in the Ovarium, the cavity which remains begins to fill up with a yellow substance, different in texture from the surrounding tissue of the Ovarium, and having, generally, a radiated centre of a whiter colour. This is the _corpus luteum_. (Plate IX., page 30 and 31; also, Spec. 3468 B and C, Gallery College of Surgeons, and Dr. Agar’s case Royal College of Physicians[4].)

35. The presence of _corpora lutea_ in the Ovarium of women, is always an indication that as many ovula have escaped from that organ; but it is not necessarily an evidence that the individual has been impregnated, as ovula have escaped without the congress of the two sexes.

36. It is inaccurate, therefore, to state that a woman has been pregnant because a _corpus luteum_ has been found in one of the Ovaria after death, or to calculate the number of children she has borne from the number of _corpora lutea_ so detected. _Corpora lutea_ have been found in the Ovaria of very young girls, of unmarried women of the strictest virtue, in newly-born female infants, and lastly, in sterile animals, such as mules. (Brugnone, Joer. Roose.)

37. Sir Everard Home’s notion that the _corpus luteum_ was formed first, and that, too, independently of sexual congress, and that the Ovulum was formed afterwards, is disproved by more accurate and recent observers. (Boer, Plagge.) There is reason to believe that Sir E. Home had been too precipitate in his inquiry[5].

38. The Ovulum, on entering the womb, is about the size of a small pea. The cavity, on the contrary, into which it enters, from the very first, is of considerable dimensions. One cannot help being struck at this great disparity in the relative dimensions of the Ovulum and the cavity of the womb. When they first come in apposition, that of the latter is from ten to twenty times greater than that of the former. (See Sir W. Blizard’s case, Royal College of Surgeons, and Spec. 73, 75, 76, in Sir C. Clarke’s Collection[6].)

39. The time at which the Ovulum enters the womb after fecundation is not precisely known. (Meckel.) The fimbriated end of the fallopian tube has been found actually applied to a Graafian vesicle after copulation. (Magendie.) An ovulum, containing the rudiments of an embryo has been observed in the human subject half engaged within the tube, and half still resting on the Ovarium. (Bussieres.) The Ovulum has been detected on its way through the fallopian tube.—(Burns, Haighton, Cruikshank, Prevost, Dumas.) It is said to have been detected in the uterine cavity on the eighth day. (Home.) Although it has lately been the fashion to doubt the accuracy of such a fact, there is reason to believe it to be correct, from the circumstance of M. Bauer’s microscopian examination of that Ovulum and description of its structure corresponding with more recent discoveries. (Boer.) The embryo contained in an Ovulum of a week’s growth has been seen and measured. (Autenrieth _Supplementa ad Historiam Embryonis Humani_.) The Ovulum, until the eighth day, has been observed in the uterus under a gelatinous form by another anatomist. (Walker.) Ovula in the fallopian tubes have also been seen on the eighth day by Prevost and Dumas.

40. I have had occasion, within the last two months, to see a perfect Ovulum ejected from the womb fourteen days after a single sexual congress, which had taken place the day after the cessation of the menses. Dr. Pockels (Isis, December 1825,) examined more than fifty human Ova, among whom four had been expelled from the womb between the eighth and sixteenth day after conception. On the fourteenth day the Ovulum is about the size of a Spanish nut. The chorion is surrounded by a thick membrane[7].

41. An Ovulum at three weeks is mentioned by Hunter (Gravid Uterus). At twenty-two days a perfect Ovulum, with the embryo clearly defined, was shewn by Dr. Combe to Dr. Baillie. Blumenbach asserts seeing an Ovulum of the size of a small cherry, which could not have had more than twenty-three days’ existence. M. Ogle’s case, published in the “Transactions of the Society for the Improvement of Medical and Surgical Knowledge”, was one of an Ovulum in Utero at five weeks. These facts contradict Burns’ assertion, that at “three weeks or a month after impregnation no fœtus is in the uterus.”

42. After being safely lodged within the cavity of the womb, the Ovulum continues to grow on its own life-principle, for a while, until its connection with the mother is effected, through the medium of the deciduous membrane, which becomes, at a more advanced period, as it were, a new and additional covering to the Ovulum. The growth of the Ovulum causes the _cortex_ to burst, as happens with the receptacle or cortex of certain seeds, and with the outer shell of the ova of some oviparous animals. (See Plate I., fig. 1, 2, 3, 4.)

43. On the cortex bursting, the lanuginous or fibrillous membrane within it (21) is exposed, when the fibrils will forthwith entwine themselves with the flocculi of the decidua, and thus the Ovulum fastens itself to the uterus by one or more contiguous points. (Carus.)

44. The membrane having these fibrils on its surface, has been called the Chorion—and from the circumstance that these fibrils, both before the cortex which lies over them has burst, as well as afterwards, serve to promote the nourishment of the fœtus, I have styled it, the nutritive membrane or involucrum of the fœtus. It has been so considered by Ruysch, who calls the villous side of the Chorion, “_succosa nutritioni fœtus inserviens_.”

45. The fibrils of the Chorion have generally been considered as filiform vessels. When examined with the microscope, they appear diaphanous and ramiform; some of them terminate into little bulbs like the ampullæ of the villosities of the intestines. These bulbs adhere so firmly to the cortex ovi, that when an attempt is made to detach them, many are lacerated. (Carus.) It is only when the cortex bursts of its own accord that they are set at liberty. (43.)

46. These fibrils, however, are not all vessels. Some are only suckers, others are real vessels. (Carus.) The existence of any vessels among the fibrils of the Chorion has been denied very recently upon the same ground, namely, microscopical observations. (Breschet and Raspail.) But there must be an evident mistake in such observations; for the actual progress of those filiform vessels, and their gradual swelling into large veins and arteries, at an advanced period of fœtation, have been noticed in examining various human ova of different ages. (Lobstein, Velpeau, Dutrochet, and myself.)

47. The nutritive envelope or involucrum, or membrane (Chorion) of the Ovum is bifoliated. I have a beautiful preparation of the transparent membranes of the Ovum, even after regular parturition, which proves this fact. It is probably even trifoliated. (Dutrochet.) A fluid has been found between the two laminæ of the Chorion. (Meckel.)

48. The internal surface of the Chorion is likewise supplied with fibrils, which connect it with the next and innermost involucrum of the fœtus, called the Amnion. Between the fibrils or filiform vessels of the two surfaces, a communication is kept up by small vascular trunks which meander between the two laminæ of the Chorion. (Meckel and myself.)

49. The vascularity of the Chorion is further proved by its diseases, chiefly of an inflammatory character, ending in the thickening of its texture. (Plate III., page 12—Plate IV., page 13—Plate V., page 17—and many other examples in this Work.) There is a preparation in Sir Charles Clarke’s collection which shews the vessels of the Chorion as evidently as if they were injected.

50. But the vascularity of the transparent membranes is proved further by fine injections thrown into the vessels of the ovaria of women; on which occasion a beautiful net-work of minute vessels is rendered manifest, forming a species of vascular ring around the _Vesiculæ Graafianæ_. The same observation has been made by comparative anatomists. (Cuvier, Home, Lobstein.)

51. These facts, demonstrative and corroborative of the vascularity of the Chorion, (45, 46, 48, 49,) explain and account for the reality of that self-existing life-principle inherent in the fecundated Ovum (42), which detaches it from its nest (vesicula Graafiana), enables it to travel through the tube, to grow or expand while thus travelling, and to maintain that same power of growth and development for a short time after its reception into the womb, until its final and effectual implantation on the maternal stock (uterus).

52. The same holds good with regard to the amnion, or inner transparent membrane of the Ovum, which, although normal anatomy has failed, morbid anatomy has succeeded in proving to be vascular. (Plate VI. fig. 20, and Description, p. 19, and Remarks, pp. 20–24.) (Haller, Monro, Chaussier, Meckel.)

53. If it be true that the amnion is a vascular membrane, there is no difficulty in viewing it also as a secreting membrane. Hence the source of that particular fluid, to which the name of Liquor Amnii has been given, and in which the embryo is suspended to the end of gestation. (Plate I. fig. 4, but particularly fig. 7, 8, and 9, and Remarks.)

54. The amnion is a sac formed by the reflected epidermis of the embryo. (Velpeau, Boer, Pockels.) It does not exist before the twelfth day. (Velpeau.) At the eighteenth day it is found as a bladder placed on the back of the embryo, and continuous to it along its edges or sides and at its extremities. (Velpeau.) It has been distinctly seen on the twelfth day. (Pockels.) It is then not a concentric membrane within the chorion, but a vesicle, on the outside of which the embryo rests as on a bed. Until the day in question the embryo is connected to the vesicular amnion at the back, by a cellular transparent membrane. From that time till the sixteenth day the embryo progressively gets into the cavity of the amnion, which before was connected with the chorion by one of its piriform extremities, while the other conical extremity penetrates slowly into the albuminous fluid of the chorion. (Pockels.)

55. While the embryo is within the chorion (nutritive involucrum) and rests on the vesicular amnion, the former membrane, or sac, contains a reddish transparent fluid having the consistency of the albumen of an egg, (54.) with a colourless and very slender membrane crossing it in various directions. (Pockels.)

56. The progressive increase of the Ovulum, from the time of its quitting the Ovarium until it has stationed itself firmly within the womb, has been demonstrated (Magendie, Prevost). In examining, between eight and twelve days after fecundation, the female organs of such of the mammalia as are multiparous at a single gestation, one Ovulum has been found near the fimbriated end of the fallopian tube of one size; a little farther into the tube another of a larger size; and lastly, near to the uterine orifice of the tube, a third of a still larger size; shewing the relative progressive increase that had taken place in such Ovula subsequently to a single act of fecundation, and proportionate to the time employed by such Ovula in travelling to the spot in which they were found. (Prevost, and Dumas’s 3rd Memoir on Generation.)

57. While thus circumstanced, the Ovulum is never connected with the part through which it passes. On plunging that part into water, the Ovulum is found not only to rise to the surface, but to float. (Home, Prevost, Dumas.)

58. What stronger proofs need be required of the existence of an inherent life-principle in the Ovulum, which is, at one time at least, (indeed I suspect throughout the period of gestation,) independent of any connection with the parent mother? (Plate I., and several of the explanations of figures throughout the work.) Yet none of the earlier writers who adopted the Ovarian theory of generation have ever asked themselves this question: What supports the vitality of a fecundated Ovulum after it has left the Ovarium, and previously to its becoming connected with the womb? In fact, the subject had never been mooted, before the more modern physiologists took it up and satisfactorily explained it[8].

59. That the embryo probably lives in utero in virtue of its own life-principle, even through the entire period of gestation, (51, 56, and 58,) is rendered probable by many facts related by unimpeached authorities, which go to prove that when the whole intact Ovum has been expelled at an advanced period of gestation, or at the natural termination of that period, the fœtus has continued to live, and the circulation of the blood has not ceased for an instant during a space of time of from nine minutes to a quarter of an hour. (Roederer, Wrisberg, Osiander, and Meckel, who repeated the experiments of the latter.) It has been asserted by a venerated authority that in an intact Ovum, expelled at seven months, the fœtus lived upwards of an hour. (Harvey.) The truth of this assertion is confirmed by very recent observers (Green, Velpeau, Gardien, Dr. Campbell)[9]. I once destroyed a female cat by prussic acid near the time of parturition; and having removed from the horns of the uterus the entire Ova, with their beautiful annular placentæ, while the fœtus in each of them was still perfectly lively, and could distinctly be seen, through the membranes, to move, I found that at the end of thirty-five, forty, and even forty-two minutes, some of them were still alive, the Ova remaining entire all the time, and upon the table[10].

60. When the Ovulum has made good its fastening to the adventitious lining of the womb (decidua), the circulation of the blood in it is as yet imperfect. The Ovulum does not—cannot—receive the blood of the mother. How could such a gossamer-like being, organized as the Ovulum has been proved to be, during the first days after fecundation, be made a part of so impetuous a torrent as the circulation of the blood of the mother, without instant destruction to the produce of conception? No. The blood of the embryo is first formed within itself. (Prevost, Home, Magendie, Adelon, Serres, Rolando.)

61. The newly-engendered being passes through two striking metamorphoses previously to the enjoyment of its extra-uterine life. These are the Embryonic and the Fœtal states. The latter succeeds immediately to the former; beginning at the moment when the new being is grafted on the maternal womb, and continuing until its expulsion from thence at the full period of gestation. It follows, therefore, that the Embryonic or former state is that in which the new being is as yet, without any direct or indirect communication with the mother, and still less so with external objects. This state persists for about two weeks after fecundation, during which the Embryo continues to derive its nourishment from the cortical membrane of the Ovum. (Boer, Soemmering, Plagge, myself.)

62. The growth and progress of the Embryo or Fœtus follow a very irregular march. Up to the second month the increase is somewhat slow—it is accelerated during the third—it slackens again at the fourth and fifth months—between which and the last month the increase is more rapid, until it has acquired its proper maturity. (Autenrieth, Soemmering.)[11]

63. The Embryo may be perceived, with the naked eye, at the fourteenth day after conception. It measures then 1–12th of an inch in length. (Dr. Pockels.) On the third week, it is 1–10th of an inch long. It is as large as a house-fly at four weeks, and as a horse-fly at six weeks. At two months it weighs twenty grains, and is one inch long. It weighs an ounce and a half at three months, and measures three inches; between which time and the sixth month it increases in dimensions from three to nine inches, and in weight from one ounce and a half to one pound. The relative weights of augmentation of length for the seventh, eighth, and ninth months stand thus:—from two to four pounds, and twelve inches; from four to five pounds, and seventeen inches: from five to eight pounds and twenty-two inches. (Averages of minute and accurate observations made by Autenrieth, Soemmering, Bichat, Pockels, Carus, &c.—confirmed by my own observations made on several early ova, and many fœtuses examined in the course of seventeen years obstetrical practice.)

64. Towards the end of the first month it is easy to distinguish the head of the fœtus, which has the appearance of a vesicle composed of thin membranes, and is as large as the rest of the body. The latter is straight—and there is in one part of the head a black dot, marking the spot for the eyes. (Plate I. fig. 5.)[12] But it is during the second month that the various parts of the face, as well as the superior and inferior extremities, become visibly delineated in the fœtus. The eyes are indicated by two black spots of considerable size, compared to the volume of the fœtus. The eyelids are not spread over them until the tenth week, at which time the external concha of the ear, as well as the profile form of the nose, become properly defined. At this same period we find the mouth, which was at first a simple opening of no mean size, becoming more distinctly delineated, owing to the formation of the lips. These soon approach each other, leaving a simple transversal slit or depression between them. (Plate II. fig. 11 and 12.)

65. The extremities appear in the form of globular tubercles at first; the superior preceding the inferior by a short period of time. Until between the third and fourth month, the lower are smaller than the superior extremities. Even at the latter month they are shorter than the projection of the os coccygis. The parts of reproduction may then be distinctly seen. In the male as well as in the female, these parts are exceedingly prominent. (Plate V. fig. 18 and 19.) But the difference of the sexes may be deduced from other circumstances besides the sexual organs. Such as the particular structure of the thorax and abdomen, the form of the head, the extremities, and the dorsal spine. (Autenrieth, Soemmering, Meckel, Velpeau.)

66. The external organs of the fœtus are all well defined at the end of the fourth month. The abdomen is fully covered in; the intestines are no longer visible. By the sixth month the fœtus is perfect in its shape and formation. In the seventh, eighth, and ninth months, its successive development is limited to mere size, volume, or amplitude, and a proportionate increase in weight. It is well to keep in mind, that although the growth of the various parts of the fœtus bears a proportion to the general development of its body, that part of the body which is above the navel, measures in length more than the part below it, until the full and complete period of gestation, when the navel marks the precise middle of the length of the fœtus. This circumstance assists us materially in forming our opinion respecting the age of any fœtus, either as a matter of curiosity, or as a guide in questions of forensic medicine. (Foderé, Chaussier.)

67. It was supposed, until within the last fifteen years, that the nervous system was the first to be formed in the human embryo; but recent discoveries have proved that the vascular system has precedence of the former. The nerves invariably appear after the arteries which they are intended to accompany. The spinal marrow appears before the brain, and the latter before the cerebellum, and accordingly it is found that the arteries of the spinal marrow shew themselves before those of the brain, and the arteries of the brain become manifest before those of the cerebellum. In this respect the organogenesy of the human fœtus is analogous to that of birds. (Serres, Desmoulins, Adelon.)[13]

68. The blood is formed independently of the heart, and appears at two distinct points from it, and acquires a motion independently of it. (Prevost, Dumas, Baer.) The veins are formed first—next, the heart—lastly, the arteries, &c. (French Physiologists.) The arteries are, by an Italian physiologist, said to be the first to appear. (Rolando.)[14]